Patient Questionnaire

General Medical Council

Regulating doctors ensuring good medical practice.

Licensed doctors are expected to seek feedback from colleagues and patients and review and act upon feedback where appropriate.

The purpose of this exercise is to provide doctors with information about their work through the eyes of those they work with and treat, and is intend to help inform their further development.

Please base your answers only on the consultation you had today. 


  1. We would like you to think about your recent experiences of our service. How likely are you to recommend our medical practice to friends and family if they needed similar care or treatment?*
    Please select an option





    (Please select from the options above)
  2. Please tell us the reason for your response: (Optional)
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  3. A little bit about you (Optional).
  4. Are you?
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  5. What age group are you?
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  6. Do you consider yourself to have a disability?
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  7. Which of the following best describes your ethnic background?

















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