Change of control of AT Medics Ltd – patient and public survey - Page 1 of 4 - North Central London ICB

1. Are you a patient at an AT Medics practice?

(Required) Yes No Don't know

2. Which GP practice are you a patient at? (Please select one answer)

(Required) St Ann's Road Surgery, Haringey Mitchison Road Surgery, Islington Hanley Primary Care Centre, Islington Kings Cross Surgery, Camden Somers Town Medical Centre, Camden Brunswick Medical Centre, Camden Camden Health Improvement Practice, Camden Other

If Other, please state the name of your GP practice

3. Are you a member of NHS staff?

(Required) Yes No

4. Which NHS organisation do you work for?

5. Which borough do you live in?

(Required) Barnet Camden Enfield Haringey Islington Other

If Other, please state which borough

Change of control of AT Medics Ltd – patient and public survey

Page 1 of 4

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