Your responses are confidential. We appreciate your patient experience feedback, aimed at improving our services for our patients.

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* 1. I am here today to see the following health care provider (check all that apply)

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* 2. When you see a Doctor or Nurse Practitioner, how often do they involve you as much as you want to be in the decisions about your care and treatment?

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* 3. When you see your Doctor or Nurse Practitioner, how often do they give you an opportunity to ask questions about the recommended treatment?

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* 4. When you see your Doctor or Nurse Practitioner, how often do they spend enough time with you?

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* 5. When the last time you were sick or had a health problem, you got an appointment on the date you wanted.

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* 6. Do you feel comfortable and welcome at Points North Family Health Team?

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* 7. Overall, how satisfied were you with your health care experience at the Points North FHT on your most recent visit?

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* 8. Do you have barriers to accessing information online?

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* 9. If you answered 'Yes, I have difficulty accessing information online' -check all that applies to you

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* 10. Did PNFHT staff show respect for your cultural and/or spiritual background (for example, language, religion, ethnic group)?

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* 11. Do you have any suggestions as to how we can improve our services? Include any additional comments you wish to share with our team.

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