Thank you for taking the time to complete this consultation survey.

All responses are anonymous and will not be used to identify individuals. Please do not include personal details such as your name.

Please do not use this survey for medical help or to raise individual issues (contact the practice directly).

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* 1. I am completing this survey:

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* 2. Which Practice are you currently registered at?

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* 3. Having read the information provided on the website, do you understand the reasons for the merger of Glenpark Medical Practice and Teams Medical Practice?

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* 4. If you have answered no or unsure, can you say why you gave that answer?

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* 5. Having read the information provided, do you support the merger of Glenpark Medical Practice and Teams Medical Practice

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* 6. If you have answered no or unsure, can you say why you gave that answer?

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* 7. If the merger goes ahead as proposed, do you think it will improve the quality of services you receive, access to appointments and choice of sites?

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* 8. If you have answered no or unsure, can you say why you gave that answer?

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* 9. If the merger goes ahead as proposed, do you think it will create any challenges or concerns for you in accessing your healthcare?

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* 10. If you have answered no or unsure, can you say why you gave that answer?

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* 11. When did you last use any services at your practice?

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* 12. When accessing GP Services, can you rank these factors in order of importance

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* 13. Is there anything else you would like to tell us about your experiences as a patient at your practice, or about the proposed merger? (please do not use this section for individual medical queries)

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* 14. Are there any changes you would like us to consider that would improve the services we offer?

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