FEEDBACK | TAKE OUR SURVEY How Are We Doing? Patient Complaint Policy (pdf) 1. What type of provider did you see today? Physician Nurse Practitioner Social Worker Dietitian Nurse Midwife Kinesiologist 2. For your appointment today, did you get an appointment on the date you wanted? Yes No 3. How many days did it take from when you first tried, or were contacted, to see your Family Health Team Member to when you actually saw him/her? Same day Next day Between 2-19 days (Please specify in comment box) 20 or more days No comment Comment Box 4. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following …? 4 a) Your overall experience with our office staff? Excellent Very Good Good Fair Poor 4 b) The length of time it took between making your appointment and the visit you just had? Excellent Very Good Good Fair Poor 5. When you see your Family Health Team Member, how often does he/she... 5 a) Give you an opportunity to ask questions about recommended treatment? Excellent Very Good Good Fair Poor 5 b) Involve you as much as you want to be in decisions about your care and treatment? Excellent Very Good Good Fair Poor 5 c) Spend enough time with you? Excellent Very Good Good Fair Poor 6. Thinking about the MAIN health care provider you spoke with during your most recent visit, how would you rate this person on the following…..? 6 a) They listened to your concerns Excellent Very Good Good Fair Poor 6 b) They explained things in a way that was easy to understand Excellent Very Good Good Fair Poor 6 c) They were sensitive to your needs and preferences Excellent Very Good Good Fair Poor 6 d) Your overall experience speaking with the health care provider about the reason for your visit Excellent Very Good Good Fair Poor 7. Please rate your overall satisfaction with your most recent appointment: Excellent Very Good Good Fair Poor 8. Would you recommend our services to your family or friends? Yes No 9. Is there any additional information or feedback you would like to share with us that could help us improve the way we provide care? Send Patient Complaint Policy (pdf)
