Mixed
?
Black or Black British
THE NHS FRIENDS AND FAMILY TEST
We would like you to think about your recent experience of our service.

How likely are you to recommend our dental practice to friends and family if they needed similar care or treatment?
Asian or Asian British
Other
Which of the following best describes your ethnic background?
Thank you for completing the form and providing us with feedback to improve our services.
If you DO NOT wish your anonymous comments to be shared then please tick here:
White
A little bit about you:
Thinking about your response to this question,what is the main reason why you feel this way?
Details:
What age are you?
65-74
45-54
85+
35-44
0-15
16-24
55-64
25-34
75-84
Female
Male
Are you?
Likely
Unlikely
Don't know
Extremely
Likely
Neither Likely
or Unlikely
Extremely
Unlikely
the patient and parent/carer
the parent or carer
the patient
Are you?
No
Do you consider yourself to
have a disability?
Yes
White and Black African
Other Black background
I would rather not say
Chinese
British
White and Black Caribbean
Bangladeshi
Pakistani
Indian
Irish
Other Asian background
White and Asian
Caribbean
Other Mixed background
Other white background
Anything else
African