TEM-01-ADM-
Clinic Feedback 2024

We know that the best way to improve our health services is to hear from members of our community. We’d like to know what you think about our service and rest assured, this information is safe with us. Your answers and information will only be used to improve our service delivery to better the health outcomes for our Aboriginal communities.

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* 1. Enter your name below (optional)

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* 2. Appointment process:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
Received reminders for your appointments?	Received reminders for your appointments? Poor	Received reminders for your appointments? Fair	Received reminders for your appointments? Good	Received reminders for your appointments? Very Good	Received reminders for your appointments? Excellent	Received reminders for your appointments? N/A
How easy was it to schedule an appointment?	How easy was it to schedule an appointment? Poor	How easy was it to schedule an appointment? Fair	How easy was it to schedule an appointment? Good	How easy was it to schedule an appointment? Very Good	How easy was it to schedule an appointment? Excellent	How easy was it to schedule an appointment? N/A
Did you encounter any issues with the booking process?	Did you encounter any issues with the booking process? Poor	Did you encounter any issues with the booking process? Fair	Did you encounter any issues with the booking process? Good	Did you encounter any issues with the booking process? Very Good	Did you encounter any issues with the booking process? Excellent	Did you encounter any issues with the booking process? N/A

Other comments

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* 3. Your experience with reception staff at your last visit:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	Not applicable	N/A
Staff were welcoming and respectful upon your arrival	Staff were welcoming and respectful upon your arrival Poor	Staff were welcoming and respectful upon your arrival Fair	Staff were welcoming and respectful upon your arrival Good	Staff were welcoming and respectful upon your arrival Very Good	Staff were welcoming and respectful upon your arrival Excellent	Staff were welcoming and respectful upon your arrival Not applicable	Staff were welcoming and respectful upon your arrival N/A
Staff communicated clearly with you about any updates/delays while you were waiting?	Staff communicated clearly with you about any updates/delays while you were waiting? Poor	Staff communicated clearly with you about any updates/delays while you were waiting? Fair	Staff communicated clearly with you about any updates/delays while you were waiting? Good	Staff communicated clearly with you about any updates/delays while you were waiting? Very Good	Staff communicated clearly with you about any updates/delays while you were waiting? Excellent	Staff communicated clearly with you about any updates/delays while you were waiting? Not applicable	Staff communicated clearly with you about any updates/delays while you were waiting? N/A
Staff checked and updated your details when you checked in?	Staff checked and updated your details when you checked in? Poor	Staff checked and updated your details when you checked in? Fair	Staff checked and updated your details when you checked in? Good	Staff checked and updated your details when you checked in? Very Good	Staff checked and updated your details when you checked in? Excellent	Staff checked and updated your details when you checked in? Not applicable	Staff checked and updated your details when you checked in? N/A

Other comments

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* 4. Wait times:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
Were you seen promptly at your scheduled appointment time?	Were you seen promptly at your scheduled appointment time? Poor	Were you seen promptly at your scheduled appointment time? Fair	Were you seen promptly at your scheduled appointment time? Good	Were you seen promptly at your scheduled appointment time? Very Good	Were you seen promptly at your scheduled appointment time? Excellent	Were you seen promptly at your scheduled appointment time? N/A
How would you rate the waiting area in terms of comfort and cleanliness?	How would you rate the waiting area in terms of comfort and cleanliness? Poor	How would you rate the waiting area in terms of comfort and cleanliness? Fair	How would you rate the waiting area in terms of comfort and cleanliness? Good	How would you rate the waiting area in terms of comfort and cleanliness? Very Good	How would you rate the waiting area in terms of comfort and cleanliness? Excellent	How would you rate the waiting area in terms of comfort and cleanliness? N/A

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* 5. Culturally safe and appropriate services:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
The staff members valued your cultural knowledge and lived experiences	The staff members valued your cultural knowledge and lived experiences Poor	The staff members valued your cultural knowledge and lived experiences Fair	The staff members valued your cultural knowledge and lived experiences Good	The staff members valued your cultural knowledge and lived experiences Very Good	The staff members valued your cultural knowledge and lived experiences Excellent	The staff members valued your cultural knowledge and lived experiences N/A
Respected your rights and ability to make your own choices	Respected your rights and ability to make your own choices Poor	Respected your rights and ability to make your own choices Fair	Respected your rights and ability to make your own choices Good	Respected your rights and ability to make your own choices Very Good	Respected your rights and ability to make your own choices Excellent	Respected your rights and ability to make your own choices N/A
You were able to build trust and relationships with your health professionals	You were able to build trust and relationships with your health professionals Poor	You were able to build trust and relationships with your health professionals Fair	You were able to build trust and relationships with your health professionals Good	You were able to build trust and relationships with your health professionals Very Good	You were able to build trust and relationships with your health professionals Excellent	You were able to build trust and relationships with your health professionals N/A
Staff were respectful to your beliefs and values	Staff were respectful to your beliefs and values Poor	Staff were respectful to your beliefs and values Fair	Staff were respectful to your beliefs and values Good	Staff were respectful to your beliefs and values Very Good	Staff were respectful to your beliefs and values Excellent	Staff were respectful to your beliefs and values N/A

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* 6. Your experience of the information given to you by health professionals at your last visit.

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
Helped you understand your medical condition and how to stay healthy	Helped you understand your medical condition and how to stay healthy Poor	Helped you understand your medical condition and how to stay healthy Fair	Helped you understand your medical condition and how to stay healthy Good	Helped you understand your medical condition and how to stay healthy Very Good	Helped you understand your medical condition and how to stay healthy Excellent	Helped you understand your medical condition and how to stay healthy N/A
How would you rate the friendliness and professionalism of our staff?	How would you rate the friendliness and professionalism of our staff? Poor	How would you rate the friendliness and professionalism of our staff? Fair	How would you rate the friendliness and professionalism of our staff? Good	How would you rate the friendliness and professionalism of our staff? Very Good	How would you rate the friendliness and professionalism of our staff? Excellent	How would you rate the friendliness and professionalism of our staff? N/A
Did the healthcare providers address your concerns adequately	Did the healthcare providers address your concerns adequately Poor	Did the healthcare providers address your concerns adequately Fair	Did the healthcare providers address your concerns adequately Good	Did the healthcare providers address your concerns adequately Very Good	Did the healthcare providers address your concerns adequately Excellent	Did the healthcare providers address your concerns adequately N/A
Explained the purpose of tests and treatments and any possible side effects	Explained the purpose of tests and treatments and any possible side effects Poor	Explained the purpose of tests and treatments and any possible side effects Fair	Explained the purpose of tests and treatments and any possible side effects Good	Explained the purpose of tests and treatments and any possible side effects Very Good	Explained the purpose of tests and treatments and any possible side effects Excellent	Explained the purpose of tests and treatments and any possible side effects N/A
Gave you helpful written information and resources	Gave you helpful written information and resources Poor	Gave you helpful written information and resources Fair	Gave you helpful written information and resources Good	Gave you helpful written information and resources Very Good	Gave you helpful written information and resources Excellent	Gave you helpful written information and resources N/A

Other comments

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* 7. Your experience of privacy at your last visit.

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
You felt comfortable to discuss personal issues that were sensitive	You felt comfortable to discuss personal issues that were sensitive Poor	You felt comfortable to discuss personal issues that were sensitive Fair	You felt comfortable to discuss personal issues that were sensitive Good	You felt comfortable to discuss personal issues that were sensitive Very Good	You felt comfortable to discuss personal issues that were sensitive Excellent	You felt comfortable to discuss personal issues that were sensitive N/A
You felt your personal information was safe	You felt your personal information was safe Poor	You felt your personal information was safe Fair	You felt your personal information was safe Good	You felt your personal information was safe Very Good	You felt your personal information was safe Excellent	You felt your personal information was safe N/A
Was your consult room door closed whilst being reviewed?	Was your consult room door closed whilst being reviewed? Poor	Was your consult room door closed whilst being reviewed? Fair	Was your consult room door closed whilst being reviewed? Good	Was your consult room door closed whilst being reviewed? Very Good	Was your consult room door closed whilst being reviewed? Excellent	Was your consult room door closed whilst being reviewed? N/A

Other comments

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* 8. Treatment effectiveness:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
Have you seen improvements in your condition since receiving treatment at our clinic?	Have you seen improvements in your condition since receiving treatment at our clinic? Poor	Have you seen improvements in your condition since receiving treatment at our clinic? Fair	Have you seen improvements in your condition since receiving treatment at our clinic? Good	Have you seen improvements in your condition since receiving treatment at our clinic? Very Good	Have you seen improvements in your condition since receiving treatment at our clinic? Excellent	Have you seen improvements in your condition since receiving treatment at our clinic? N/A
Did the treatment plan meet your expectations?	Did the treatment plan meet your expectations? Poor	Did the treatment plan meet your expectations? Fair	Did the treatment plan meet your expectations? Good	Did the treatment plan meet your expectations? Very Good	Did the treatment plan meet your expectations? Excellent	Did the treatment plan meet your expectations? N/A
Were you given clear instructions for any necessary follow-up care?	Were you given clear instructions for any necessary follow-up care? Poor	Were you given clear instructions for any necessary follow-up care? Fair	Were you given clear instructions for any necessary follow-up care? Good	Were you given clear instructions for any necessary follow-up care? Very Good	Were you given clear instructions for any necessary follow-up care? Excellent	Were you given clear instructions for any necessary follow-up care? N/A
Did the clinic follow up with you after your visit?	Did the clinic follow up with you after your visit? Poor	Did the clinic follow up with you after your visit? Fair	Did the clinic follow up with you after your visit? Good	Did the clinic follow up with you after your visit? Very Good	Did the clinic follow up with you after your visit? Excellent	Did the clinic follow up with you after your visit? N/A

Other comments

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* 9. Facilities and cleanliness:

Please rate each statement below.

	Poor	Fair	Good	Very Good	Excellent	N/A
How clean and well maintained did you find our facilities?	How clean and well maintained did you find our facilities? Poor	How clean and well maintained did you find our facilities? Fair	How clean and well maintained did you find our facilities? Good	How clean and well maintained did you find our facilities? Very Good	How clean and well maintained did you find our facilities? Excellent	How clean and well maintained did you find our facilities? N/A
Were the facilities comfortable and accommodating?	Were the facilities comfortable and accommodating? Poor	Were the facilities comfortable and accommodating? Fair	Were the facilities comfortable and accommodating? Good	Were the facilities comfortable and accommodating? Very Good	Were the facilities comfortable and accommodating? Excellent	Were the facilities comfortable and accommodating? N/A

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* 10. Overall experience:

	Poor	Fair	Good	Very Good	Excellent	N/A
How would you rate your overall experience at our health clinic?	How would you rate your overall experience at our health clinic? Poor	How would you rate your overall experience at our health clinic? Fair	How would you rate your overall experience at our health clinic? Good	How would you rate your overall experience at our health clinic? Very Good	How would you rate your overall experience at our health clinic? Excellent	How would you rate your overall experience at our health clinic? N/A

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* 11. Were you satisfied with the quality of care you received?

Please rate this statement below.

Dissatisfied

Somewhat dissatisfied

Neither satisfied nor dissatisfied

Satisfied

Very Satisfied

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* 12. What areas do you think the clinic could improve on?

Thank you for taking the time to complete this questionnaire and sharing your feedback with us. We appreciate your time and patience and greatly value your input.

TEM-01-ADM-Clinic Feedback 2024

Question Title

* 1. Enter your name below (optional)

Question Title

* 2. Appointment process:Please rate each statement below.

Question Title

* 3. Your experience with reception staff at your last visit:Please rate each statement below.

Question Title

* 4. Wait times:Please rate each statement below.

Question Title

* 5. Culturally safe and appropriate services:Please rate each statement below.

Question Title

* 6. Your experience of the information given to you by health professionals at your last visit.Please rate each statement below.

Question Title

* 7. Your experience of privacy at your last visit.Please rate each statement below.

Question Title

* 8. Treatment effectiveness: Please rate each statement below.

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* 9. Facilities and cleanliness:Please rate each statement below.

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* 10. Overall experience:

Question Title

* 11. Were you satisfied with the quality of care you received?Please rate this statement below.

Question Title

* 12. What areas do you think the clinic could improve on?

TEM-01-ADM-
Clinic Feedback 2024

* 2. Appointment process:

Please rate each statement below.

* 3. Your experience with reception staff at your last visit:

Please rate each statement below.

* 4. Wait times:

Please rate each statement below.

* 5. Culturally safe and appropriate services:

Please rate each statement below.

* 6. Your experience of the information given to you by health professionals at your last visit.

Please rate each statement below.

* 7. Your experience of privacy at your last visit.

Please rate each statement below.

* 8. Treatment effectiveness:

Please rate each statement below.

* 9. Facilities and cleanliness:

Please rate each statement below.

* 11. Were you satisfied with the quality of care you received?

Please rate this statement below.