Client Satisfaction Feedback Question Title * 1. What Clinic did you attend for today's appointment? Rainforest Coral Cay Mangrove Edmonton Jalbu Women's Hub Access and Availability Question Title * 2. How easy was it for you to make an appointment with us? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 3. Were the services operating hours convenient for you? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 4. Did you experience any delays in receiving care when you needed it? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 5. How would you rate the availability of services provided by us? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Communication and Interpersonal Skills of Administrative Staff Question Title * 6. How welcoming and respectful were the administrative staff when you arrived? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 7. Did the administrative staff explain the processes clearly to you? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 8. How well did the administrative staff listen to your concerns? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 9. Were the administrative staff able to answer your questions effectively? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Communication and Interpersonal Skills of service delivery Staff Question Title * 10. How respectful and understanding were our staff during your visit? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 11. Did we explain your health condition and treatment options clearly? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 12. How well did our staff listen to your concerns and questions? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 13. Did you feel comfortable discussing your health issues with the relevant staff? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Experience of staff member Communication During Last Visit Question Title * 14. How clearly did the health professional explain your diagnosis and treatment plan? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 15. Did they take the time to listen to your concerns and answer your questions? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 16. How respectful and empathetic was the staff member during your visit? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 17. Did you feel that the staff member understood your cultural background and needs? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Provision of Information Question Title * 18. How clear and helpful was the information provided about your health condition? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 19. Did you receive enough information about your treatment options? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 20. How easy was it to understand the written materials provided by the clinic? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 21. Were you given information about how to manage your health at home? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Privacy and Confidentiality Question Title * 22. How confident are you that your personal health information is kept private? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 23. Did the staff explain how your information would be used and protected? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 24. How comfortable did you feel discussing sensitive health issues at the health service? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 25. Were you given the option to discuss your health concerns in a private setting? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Continuity of Care Question Title * 26. How well did the staff coordinate your care with other healthcare providers? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 27. Did you feel that your care was consistent and continuous over time? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 28. How easy was it to follow up with the same health provider for ongoing care? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 29. Were you informed about the next steps in your care plan? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Experience Over the Last Year Question Title * 30. How would you rate your overall experience with the health service over the past year? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 31. Did you notice any improvements in the services provided by the service? Yes No Question Title * 32. How well did Wuchopperen meet your healthcare needs over the past year? Poor Good Very Good Excellent N/A Poor Good Very Good Excellent N/A Question Title * 33. Would you recommend Wuchopperen to other members of your community? Yes No For your chance to WIN $100 Coles Voucher, please tell us a little about yourself! Question Title * 34. Your Name Question Title * 35. Contact Phone Number: Question Title * 36. Your Age: Under 18 18-24 25-34 35-44 45-54 55-64 65+ Question Title * 37. Your Gender Male Female Other Prefer not to say Done
