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Community Health Worker (CHW) Services (Allied Survey 2026)
You are being invited to take part in this survey because you have recently had a visit fo
r Community Health Worker (CHW) services at East End CHC.
Your responses to the questions on this survey will help us improve the CHW services we provide. This survey will take approximately 5 minutes to complete. Participation in the survey is voluntary and all your responses to the survey questions will be kept confidential.
Q1. Thinking about the last visit you had for CHW (Community Health Worker) services, on a scale of poor to excellent, how would you rate the following?
a) They listened to your concerns
Poor
Fair
Good
Very Good
Excellent
b) They explained things in a way that was easy to understand
Poor
Fair
Good
Very Good
Excellent
c) They were sensitive to your needs and preferences
Poor
Fair
Good
Very Good
Excellent
d) They treated you with dignity and respect
Poor
Fair
Good
Very Good
Excellent
e) Your overall experience speaking with the CHW (Community Health Worker) about the reason for your visit
Poor
Fair
Good
Very Good
Excellent
f) Your overall experience accessing the Centre
Poor
Fair
Good
Very Good
Excellent
g) The length of time it took between making your appointment and the visit you just had
Poor
Fair
Good
Very Good
Excellent
Q2. The last time you booked an appointment with a CHW (Community Health Worker), did you get an appointment on the date you wanted?
No
Yes
Q3. When you see the CHW (Community Health Worker), how
often
do they…?
a) Give you an opportunity to ask questions
Never
Rarely
Sometimes
Often
Always
b) Involve you as much as you want to be in decisions about your care
Never
Rarely
Sometimes
Often
Always
c) Spend enough time with you
Never
Rarely
Sometimes
Often
Always
d) Clearly explain your action plan/what to do after your visit
Never
Rarely
Sometimes
Often
Always
Q4. I always feel comfortable and welcome at East End Community Health Centre (CHC).
No
Yes
Q5. Seeing a CHW (Community Health Worker) ...
a) helped assess my current concerns and issues
Strongly Disagree
Disagree
Neither Agree
nor Disagree
Agree
Strongly Agree
b) helped increase my awareness and access to community resources
Strongly Disagree
Disagree
Neither Agree
nor Disagree
Agree
Strongly Agree
c) helped develop strategies to better manage my situation going forward
Strongly Disagree
Disagree
Neither Agree
nor Disagree
Agree
Strongly Agree
Q6. CHW (Community Health Worker) Services in the Future
a) If a friend were in need of similar help, would you recommend a CHW (Community Health Worker) at this CHC (Community Health Centre) to them?
No, definitely not
No, I don't think so
I'm not sure
Yes, I think so
Yes, definitely
b) If you needed help again, would you seek out CHW (Community Health Worker) services at this CHC (Community Health Centre) again?
No, definitely not
No, I don't think so
I'm not sure
Yes, I think so
Yes, definitely
Q7. If CHW (Community Health Worker) services were not offered at the CHC (Community Health Centre), would you have been able to access these services elsewhere?
No
Yes
If
not,
why not?
(Check ALL that apply)
I can’t afford CHW (Community Health Worker) /I don’t have private health insurance
I don’t know where to go to get a CHW (Community Health Worker)
I can't go to other CHW (Community Health Worker) locations
I don’t want to go anywhere outside of the CHC (Community Health Centre) for my health care
Other (please specify)
Context/Demographics
How long have you been visiting us for your health care?
Less than six months
Between six months and a year
Between one and three years
Between three and five years
Longer than five years
Using your best guess, how many times did you visit the Centre over the past year or so for your own health care?
One
Two
Three
Four
Five or more
Would you recommend our services to your family and friends?
Definitely no
Probably no
Probably yes
Definitely yes