Patient Survey

We welcome your feedback

Make an Appointment

Request an Appointment Online

Health- Co-Pilot

Shifnal & Priorslee Medical
Practice Patient Survey

Required fields are marked with an asterisk (*).

25%
Please answer the questions below by selecting the relevant answer in the box for each question unless more than one answer is allowed (these questions are clearly marked). We will keep your answers completely confidential.
Your GP practice services

By ‘online’ we mean on a website or smartphone app. Please select all options that apply

Your last contact

Only think about the last time you tried to contact your GP practice for yourself or someone else

The main reason was to:

I (or the person I was contacting the practice for) was:

Your last appointment

The next few questions are about the last time you had an appointment for yourself.

Include appointments with different healthcare professionals, at different locations, whether online, by text, over the phone or in person

Include appointments with different healthcare professionals, at different locations, whether online, by text, over the phone or in person

Please select all the boxes that apply.

Overall experience

Some questions about you

This survey is now closed for 2025

Thank you for your responses

We're here for you

Please note this Change of Name Form is not to be used for the following purposes:

Medical matters, Prescription requests, Patient Access requests, Appointment requests or Complaints. Medical matters cannot be dealt with via this form. If you have a query regarding a medical matter please telephone reception to make an appointment to see the appropriate person.

Other forms available

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