Tower Family Healthcare

Patient Questionnaire

Minden Family Practices intends to merge with the following practices over the course of the next 6-12 months to become Tower Family Healthcare:

Greenmount Medical Centre

Tottington Medical Practice

Uplands Medical Practice, Whitefield

Spring Lane Surgery, Radcliffe

An important step in our merger plans is to engage with you to fully understand those things you value the most about our practice and what things we could do to make it even better! Understanding your views will enable Tower Family Healthcare to maintain and build upon the best of what we do now and will also help to make our services even better for you in the future.

Merging practices is a big step for all of us and one which we are very excited about. We would therefore also like to understand your views on our merger plans and would be grateful if you could take a few minutes to complete this important questionnaire. Once complete, please print and hand to a member of our reception team or email direct to

Patient Questionnaire

Minden Family Practices

  1. What do we do well?
  1. Our practice would be even better if…

______

About our merger plans…

  1. What excites you most?
  1. What (if any) concerns do you have?
  1. How would you like us to tell you about our plans?

*Please continue overleaf / on a separate sheet if necessary

Continued over…

Equality monitoring

This anonymous equality monitoring form provides an option to declare which protected groups you identify with. This information will be used to help us understand which groups use our services. We want to reach all sections of our local communities, and ensure that local people have fair access to our services, healthcare information, and a fair patient experience.

What is your ethnic group?
Choose ONE section from A to E, then tick the appropriate box to indicate your ethnic group.
A: White
 British
 Irish
 East European
 Gypsy/Roma/Traveler
White other background (please write in) ______
B: Mixed
 White and Black Caribbean
 White and Black African
 White and Asian
 Mixed other background (please write in) ______
C: Asian or Asian British
 Indian
 Pakistani
 Bangladeshi
 Asian other background (please write in) ______
D: Black or Black British
 Caribbean
African
 Any other Black background (please write in)______
E: Chinese or other ethnic group
 Chinese
 Any other (please write in) ______
 Prefer not to say

Confidential anonymous information subject to Data Protection Act requirements