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? 
Extremely Likely
Likely
Neither Likely or Unlikely
Unlikely
Extremely Unlikely
I Don't Know
Thinking about your response to this question, what is the main reason why you feel this way? 
Male
Female
Do you consider yourself to have a disability? 
Which of the following best describes your ethnic background? 
British
Irish
Other white background
Indian
Pakistani
Bangladeshi
Chinese
Other Asian background
White & Black Caribbean
White & Black African
White & Asian
Other Mixed Background
Caribbean
African
Other Black background
Anything Else
I would rather not say
The Patient
The Parent or carer
The patient & parent/carer
Thank you for completing this survey and providing us with feedback to improve our service. If you DO NOT wish your anonymous comment to be shared then please tick here: 
Please Tick
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