Friends and Family Test Please do not use this service regarding clinical issues, emergency medical problems, appointments or prescription requests. Please contact your surgery directly. Page 1 of 2Which practice are you registered with?*Please selectBlossomfield SurgeryDickens Heath Medical CentreHaslucks Green Medical CentreGrove SurgeryMonkspath SurgeryShirley Medical CentreThe Jacey PracticeHow likely are you to recommend our GP practice to friends and family if they needed similar care or treatment?*Extremely likelyLikelyNeither likely nor unlikelyUnlikelyExtremely unlikelyDon't knowCan you tell us why you gave that response?Do you consent to us publishing your comment anonymously on our website.NoYesNextOptional questionsWhat is your gender?MaleFemaleOther, or prefer not to sayHow old are you?0-1516-2425-3435-4445-5455-6465-7475+How are you entering your results?In response to a text messageIn response to an emailIn response to a letterFrom browsing the websiteBackSendThis field should be left blank