Railside Surgery Patient Feedback
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Are you a
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What is your age?
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Gender
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Ethnicity
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What surgery do you normally visit?
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How many times have you visited Railway Street Surgery in the past 12 months?
In the event the Railway Street surgery closed permanently, how would you access GP services?
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Have you ever visited Balmoral Gardens? If so how did you find access and the services provided at this site?
To what extent to you agree or disagree with the proposed closure of Railway Street Surgery?
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  Please tell us why you chose your answer
If Railway street surgery did close, what impact would this have on you or your family?
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How would you normally get to Railway Street surgery?
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Would the closure of Railside affect your ability to attend appointments at other sites? Appointments would still be allocated based on upon address, so this would highly likely be at Balmoral Gardens
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