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Extended Access Service - Patient Input
About You
Knowing a bit more about you helps us to fully understand the information we gather to improve our services.
1.
What age bracket do you fall into?
Under 18
18-24
25-34
35-44
45-54
55-64
65+
Prefer Not to Answer
2.
What gender are you?
Male
Female
Non-Binary
Prefer Not to Answer
Other (please specify)
3.
What is your ethnicity?
Asian/Asian British
Black/Black British/Caribbean/African
Mixed/Multiple Ethnic Groups
Traveller/Roma/Gypsy
White (incl. British, Irish, Other)
Prefer Not to Answer
Other (please specify)
4.
What is your employment status?
Employed - Full-Time
Employed - Part-Time
Self-Employed
Not Employed and Looking for Work
Not Employed and Not Looking for Work
Carer
Retired
Student
Homemaker
Prefer Not to Answer
5.
What is your preferred method of travel?
Car
Bus / Public Transport
Taxi
Bike
Travel by Foot
Prefer Not to Answer
6.
Which GP Practice are you registered at?
Alma Medical Centre
The Arrival Medical Practice
Bank House Surgery
Chadwick Practice
Densham Surgery
The Dovecot Surgery
Dr Rasool
Eaglescliffe Medical Practice
Elm Tree Surgery
Gladstone Surgery
Hart Medical Practice
Havelock Grange
The Headland Medical Practice
Kingsway Medical Centre
The Koh Practice
Marsh House Medical Centre
McKenzie Group Practice
Melrose Medical Centre
Norton Medical Centre
Park Lane Surgery
Queenspark Medical Centre
Queenstree Practice
Riverside Medical Practice
The Roseberry Practice
Seaton Surgery
Tennant Street Medical Practice
Thornaby and Barwick Medical Group
West View Millennium Practice
Woodbridge Practice
Woodlands Family Medical Centre
Yarm Medical Practice
