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Date: 28 April 2015

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The Friends and Family TestWe would like you to think about your experience at our Community Hospital.
Please note - the full name of the hospital ward or MIU is listed below, replacing the shortcode on the paper form. E.g. if you have a paper form which says the code is BODANC - you will need to select Bodmin Anchor Ward.
Items marked with a * must be filled.

How likely are you to recommend our Minor Injury Unit or Ward to friends and family if they needed similar care or treatment?

How Likely? *


Please can you tell us the main reason for the score you have given?


If you have an issue or concern you would like to discuss further, or require this information to be presented in a different format or language, please contact our Patient Advice & Liaison Service (PALS) on 03003 301444
 The following information helps us to understand how different groups of people feel about their experiences using our service.


Gender (Please tick all boxes that apply)


Ethnic Group

Thank you for taking the time to tell us about your experience. Your feedback will be used to improve our service.

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Peninsula Community HealthSedgemoor Centre Priory Road St Austell Cornwall PL25 5AS Phone: 01726 627800
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