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CLIENT FEEDBACK SURVEY
We want to hear from you! Your feedback helps us serve you and others better. Thank you for your time.
PART 1: GETTING HELP FROM THE CLINIC
1.
How did you first contact the clinic?
Phone
Email
Website
Walk-In
Other:
2.
Was it easy to contact us and get help?
Yes
No
If no, please explain:
3.
How long did it take someone to respond to you?
Right Away
Within 48 hours
More than 48 hours
4.
Were our hours of service convenient for you?
Yes
No
If no, please explain:
PART 2: COMMUNICATION
5.
Did staff explain things in a way you can understand?
Yes, very clearly
somewhat clearly
No, I had trouble understanding
6.
Did we give you updates on your case?
Yes, often
Sometimes
No, I didn’t get updates
7.
Did we communicate with you in your preferred language (English or French)
Yes
No
I do not have a preference
8.
Was interpretation made available?
Yes
No
Not Applicable
9.
If you had questions, did staff take the time to answer them?
Yes
No
If no, please explain:
PART 3: RESPECT AND SERVICE
10.
I felt welcomed when I came to the clinic.
Yes
No
If no, please explain:
11.
I was treated with dignity and compassion.
Yes
No
If no, please explain:
12.
Staff listened to my concerns and took them seriously.
Yes
No
If no, please explain:
13.
I felt that the staff cared about my situation.
Yes
No
If no, please explain:
14.
I felt safe and comfortable during all interactions with the clinic.
Yes
No
If no, please explain:
PART 4: LEGAL SERVICES
15.
I received clear information about my legal rights.
Yes
No
If no, please explain:
16.
I understood what steps were being taken in my case.
Yes
No
If no, please explain:
17.
I felt confident in the legal help I received.
Yes
No
If no, please explain:
18.
The outcome of my case met my expectations (based on what was possible).
Yes
No
If no, please explain:
19.
The clinic helped me take action or resolve my legal issue.
Yes
No
If no, please explain
PART 5: OVERALL EXPERIENCE
20.
How would you rate your overall experience at the clinic?
Excellent
Good
Okay
Poor
Excellent
Good
Okay
Poor
21.
Would you come back to the clinic if you need help again?
Yes
No
If no, please explain:
22.
Would you recommend our clinic to someone else?
Yes
No
If no, please explain:
23.
What did you like most about the clinic?
24.
What can we do better?
25.
Would you like us to connect you about your feedback?
Yes
No
If no, please explain:
26.
If yes, your name and contact information (optional):
