Client Satisfaction Survey

 

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* 1. Please select the service which you are completing this survey for:

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* 2. Please read the following statements keeping in mind the care you are receiving. We are interested in your feelings, good and bad, about the health care you have received. Your responses will remain confidential and will be grouped with other responses.  Your participation in this survey is voluntary.

How strongly do you AGREE or DISAGREE with each of the following statements?

  Strongly Disagree Disagree Uncertain Agree Strongly Agree
The staff treat me in a friendly and courteous manner.
I feel staff listen to what I have to say.
I feel my cultural beliefs are respected by the staff.
I do not feel rushed when the staff provide services.
I have a say in my care.
I feel the staff explain things to me and answer my questions.
I am satisfied with the care I have received.
I feel I receive health teachings and support from the staff.
I feel confident in the care I am receiving.
I feel I am treated with dignity and respect.

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* 3. Do you feel you can make a complaint about services if needed?

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* 4. If you could change anything about the services of Fort Frances Tribal Area Health Services, what would it be?

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* 5. Would you recommend Fort Frances Tribal Area Health Services to your friends and family?

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* 6. We welcome any other comments.

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* 7. Contact name and telephone number (optional):

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* 8. Would you like to be contacted to discuss your response?

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* 9. Completed by:

Miigwech for taking the time to complete this survey!

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