Dear Patient,

At Barrie Endoscopy, we are committed to providing you with the best possible healthcare. We are interested in knowing what you think about our services. You can help us evaluate our performance by completing this brief (5 minute) survey regarding your visit.

Thank you for taking time to share your experience with us.

Please tell us the date of your procedure

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* 1. Please tell us the date of your procedure

Date / Time
If you spoke to the facility by phone, how helpful was the person you spoke with?

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* 2. If you spoke to the facility by phone, how helpful was the person you spoke with?

Ease of scheduling your procedure

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* 3. Ease of scheduling your procedure

The ease of the check-in process

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* 4. The ease of the check-in process

The comfort, cleanliness, and amenities of the facility

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* 5. The comfort, cleanliness, and amenities of the facility

Clear and sufficient instructions on what to do and what to expect before your procedure

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* 6. Clear and sufficient instructions on what to do and what to expect before your procedure

The wait time in our facility, compared to your expectations

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* 7. The wait time in our facility, compared to your expectations

The courtesy and caring of your physician

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* 8. The courtesy and caring of your physician

The courtesy and caring of the nursing and support staff

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* 9. The courtesy and caring of the nursing and support staff

Skills of assisting staff (i.e anesthesiologist)

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* 10. Skills of assisting staff (i.e anesthesiologist)

Comfort level within the procedure room

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* 11. Comfort level within the procedure room

Usefulness of the information provided about what was done during the procedure

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* 12. Usefulness of the information provided about what was done during the procedure

Clear and sufficient instructions on what to do and what to expect after your procedure

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* 13. Clear and sufficient instructions on what to do and what to expect after your procedure

Overall, how would you rate the teamwork between the doctors, nurses and other staff?

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* 14. Overall, how would you rate the teamwork between the doctors, nurses and other staff?

Overall, how satisfied were you with the procedure experience?

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* 15. Overall, how satisfied were you with the procedure experience?

Was this your first visit as a patient to our facility?

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* 16. Was this your first visit as a patient to our facility?

Would you recommend our facility to others?

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* 17. Would you recommend our facility to others?

Please add any comments you have regarding your experience? Please feel free to tell us on ways that you feel we could improve our services and the overall experience of our patients.

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* 18. Please add any comments you have regarding your experience? Please feel free to tell us on ways that you feel we could improve our services and the overall experience of our patients.

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