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