CSCE Client Experience Survey Thank you for taking a few minutes of your time to answer the following questions.Your answers will help us improve our programs and services. OK Question Title * 1. At which location do you access services? Bourget Crysler Embrun Cornwall Alexandria Limoges OK Question Title * 2. The Centre de santé communautaire de l’Estrie is conveniently located. Yes No Does not apply OK Question Title * 3. Over the past year, I had to go to another clinic or to the emergency room because I could not get an appointment at the Centre de santé communautaire de l’Estrie. Yes No Does not apply OK Question Title * 4. When needed, I can get an appointment for an urgent matter with a doctor or nurse practitioner at the Centre de santé communautaire de l’Estrie. Always Often Sometimes Rarely Never Does not apply OK Question Title * 5. When I book an appointment at the Centre de santé communautaire de l’Estrie, I am satisfied with the date provided. Always Often Sometimes Rarely Never Does not apply OK Question Title * 6. After seeing a professional at the Centre de santé communautaire de l’Estrie, I can get a follow-up appointment within the time frame requested by this individual. Always Often Sometimes Rarely Never Does not apply OK Question Title * 7. The last time you were sick or concerned about a health problem, how many days elapsed between the time you tried to see your doctor or nurse practitioner and the time you actually SAW him/her or someone else at the Centre de santé communautaire de l’Estrie? Same day Next day Two days later Three days later More than three days later Does not apply OK Question Title * 8. What can the Centre de santé communautaire de l’Estrie do to improve access to its programs and services? OK Question Title * 9. My doctor or nurse practitioner allows me to ask questions about the recommended treatment. Always Often Sometimes Rarely Never Does not apply OK Question Title * 10. I feel that my doctor or nurse practitioner involves me in the decisions that affect my care and treatment. Always Often Sometimes Rarely Never Does not apply OK Question Title * 11. I feel that my doctor or nurse practitioner spends enough time with me during each visit. Always Often Sometimes Rarely Never Does not apply OK Question Title * 12. The employees at the Centre de santé communautaire de l’Estrie help me find community programs and services that meet my needs. Always Often Sometimes Rarely Never Does not apply OK Question Title * 13. The programs and services offered by the Centre de santé communautaire de l’Estrie meet my needs. Always Often Sometimes Rarely Never Does not apply OK Question Title * 14. I can obtain services in the language of my choice. Always Often Sometimes Rarely Never Does not apply OK Question Title * 15. I always feel comfortable and welcome at the Centre de santé communautaire de l’Estrie. Always Often Sometimes Rarely Never Does not apply If you answered "Sometimes", "Rarely" or "Never" to the previous question, please explain why you feel this way OK Question Title * 16. When I receive services at the Centre de santé communautaire de l’Estrie, I feel that the employees respect my dignity. Always Often Sometimes Rarely Never Does not apply If you answered "Sometimes", "Rarely" or "Never" to the previous question, please explain why you feel this way OK Question Title * 17. I feel that the employees at the Centre de santé communautaire de l’Estrie respect my differences (cultural, physical, intellectual, religious, sexual orientation, gender identity, etc.). Always Often Sometimes Rarely Never Does not apply If you answered "Sometimes", "Rarely" or "Never" to the previous question, please explain why you feel this way OK Question Title * 18. I feel that the Centre de santé communautaire de l’Estrie respects my right to privacy and confidentiality. Always Often Sometimes Rarely Never Does not apply OK Question Title * 19. When I am at the Centre de santé communautaire de l’Estrie, I worry that other people may overhear my private conversations. Always Often Sometimes Rarely Never Does not apply OK Question Title * 20. I am confident that my personal health information is adequately protected. Always Often Sometimes Rarely Never Does not apply OK Question Title * 21. In general, when I arrive at the Centre de santé communautaire de l’Estrie for an appointment, someone comes to get me Before my scheduled appointment At the appointed time Less than 10 minutes after my scheduled appointment 10-19 minutes after my scheduled appointment 20-29 minutes after my scheduled appointment 30 minutes or more after my schedules appointment OK Question Title * 22. I am satisfied with this wait time. Always Often Sometimes Rarely Never Does not apply OK Question Title * 23. I am pleased with the reception staff and with the way that I am greeted. Always Often Sometimes Rarely Never Does not apply OK Question Title * 24. I feel that the employees at the Centre de santé communautaire de l’Estrie are respectful and professional. Always Often Sometimes Rarely Never Does not apply OK Question Title * 25. I would refer a family member or a friend to the Centre de santé communautaire de l’Estrie. Always Often Sometimes Rarely Never Does not apply OK Question Title * 26. I have visited the Centre de santé communautaire de l’Estrie’s website in the past. Always Often Sometimes Rarely Never I was not aware the CSCE had a website OK Question Title * 27. I can easily find the information I am looking for on the Centre de santé communautaire de l’Estrie’s website. Always Often Sometimes Rarely Never Does not apply OK Question Title * 28. How can the Centre de santé communautaire de l’Estrie improve its services? OK Question Title * 29. In general, would you say your overall physical health is: Excellent Very good Good Fair Poor OK Question Title * 30. How long have you been a client at the Centre de santé communautaire de l’Estrie? Less than 6 months 6 - 12 months 1 - 2 years 3 - 4 years 5 - 10 years More than 10 years OK Question Title * 31. Over the past year, how many times did you visit the Centre de santé communautaire de l’Estrie for your medical needs? (Please answer to the best of your knowledge.) Once Twice Three times Four times Five times More than five times OK Question Title * 32. Please indicate your age 12-17 18-24 25-34 35-49 50-64 65-75 75 and over OK Question Title * 33. Which of the following best describes your gender? Female Male Intersex Transgender - male to female Transgender- female to male Two spirit I do not know I prefer not answer Other (please specify): OK Question Title * 34. What was your household’s TOTAL annual income last year? Less than $15,000 $15,000- $30,000 $30,000- $45,000 $45,000- $60,000 $60,000-$75,000 $75,000-$100,000 More than $100,000 I prefer not to answer OK Thank you! We are thinking of organizing community forums and inviting clients to share what they like about the programs and services offered at the Centre de santé communautaire de l’Estrie, what can be improved and how we can better serve you. OK Question Title * 35. IF YOU PREFER YOUR ANSWERS TO REMAIN ANONYMOUS, YOU MAY CHOOSE NOT TO SHARE YOUR CONTACT INFORMATION BELOW. Name Email Telephone OK DONE