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IQVIA Connection Desktop - Complete Questionnaire
Please complete the form below. Please use the text boxes provided to add any comments.


Childrens FFT Survey
Borough
Service
Which service did you attend?
TRUST REPORTING STRUCTURE
Where was your appointment?
Are you:

Tell us what you think
1Overall, how was your experience of our service?
Very goodGoodNeither good nor poorPoorVery poorDon't know
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2What is the main reason for your answer?
3What did you find most helpful from your care?
4What could we do better?
5If you would like to tell us more about your experience, please tick this box and complete your contact details below:
YesNo

Questions about you: This section is optional
Please tell us more about you. This will make the things you tell us even more helpful
6Ethnicity:
BlackAsianWhiteMixed raceOther
7My/my child’s age:
0-45-1112-1617-2122+
8Gender:
MaleFemaleOther
9Does your health or disability make it hard to do things in your daily life?
Yes, a lotYes, a littleNoDon't know/don't want to say

This survey does not ask for your name. If you want to leave your contact details, you can write them below:
10Name:
11Email:
12Tel:

Complete Survey