patient virtual participation groupMaking Services Better: Your Views

Signing up for Patient Virtual Participation Group

Mr  Mrs  Miss  Ms

The information below will help to make sure that we receive feedback from a representative sample of the patients registered at this practice.
Male Female
Under 16 17-24
25-34 35-44
45-54 55-64
65-74 75-84
Over 84

The ethnic background with which you most closely identify is:

British Group Irish
White & Black Caribbean White & Black African
White & Black Asian
Asian or Asian British Indian Pakistani
Bangladeshi
Black or Black British Caribbean African
Chinese or Other Chinese Any Other

How would you describe how often you come to the practice?

Regularly Occasionally Very Rarely