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* 1. Please list the name of the profession you are currently practising:

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* 2. Please provide the first three characters of your workplace postal code:

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* 3. Please indicate your age range:

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* 4. Please indicate your gender:

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* 5. What is your mother tongue (first language learned and still understood)?

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* 6. Which language is most often spoken in your home?

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* 7. Where were you born?

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* 8. How often do you use French in the workplace?

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* 9. To the best of your knowledge, what percentage of your patients speak French?

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* 10. To the best of your knowledge, are measures taken in your workplace to let patients know that some staff members speak French?

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* 11. Please indicate what measures are taken:

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* 12. Do you take measures to let your patients know that you speak French?

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* 13. Please list the measures you are taking:

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* 14. Have you personally heard that patients find it difficult accessing French-language health services?

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* 15. If yes, was it because: (check all applicable answers)

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* 16. Do you have any suggestions on how to improve access to French-language health services?

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