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Ear Falls Community Health Centre/Family Health Team Patient Experience Survey 2025-2026
1.
Who did you see today?
Doctor
Nurse
Both
2.
Have you completed this survey in the last 3 months?
Yes
No
3.
Select your Age Group
Under 18
18 - 44
45 - 64
65+
4.
How would you describe your overall health?
Excellent
Very Good
Good
Fair
Poor
5.
In the last 12 months, how often have you been in to see the doctor or nurse?
1 - 2
3 - 4
5+
6.
The last time you were sick, how many days did it take to be seen?
Same Day
Next Day
3+ Days
7.
Was this timeframe satisfactory?
Yes
No
8.
Are you satisfied with the ease of booking an appointment with your health care provider?
Satisfied
Neutral
Dissatisfied
9.
Do you feel you are able to get a routine appointment in an appropriate timeframe?
Always
Often
Sometimes
Rarely
Never
10.
Do you feel comfortable and welcomed by the staff of the Ear Falls Clinic?
Always
Often
Sometimes
Rarely
Never
11.
Do you feel involved in your care/treatments when you see your doctor or nurse? Are you given an opportunity to ask questions?
Always
Often
Sometimes
Rarely
Never
12.
What is one thing we could do to make your experience better?
13.
Other Comments?
14.
Thank you for completing this survey! Please enter your name for a chance to win a prize! (Optional)
All your responses to the survey questions will be kept confidential.
