Laboratory Outpatient Client Experience Survey

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* 1. From the time you arrived at the laboratory, the collection time was

Less than 20 minutes

20 - 30 minutes

30 - 40 minutes

More than 40 minutes

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* 2. If you waited more than 40 minutes, was the reason for the delay explained to you?

Yes

I did not wait more than 40 minutes

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* 3. Did the phlebotomist(s) (person collecting the blood) introduce themselves to you?

Yes

N/A (I already knew the phlebotomist)

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* 4. Please answer the following questions about the phlebotomist's care.

	Always	Usually	Sometimes	Never
Did the phlebotomist explain their role before offering care?	Did the phlebotomist explain their role before offering care? Always	Did the phlebotomist explain their role before offering care? Usually	Did the phlebotomist explain their role before offering care? Sometimes	Did the phlebotomist explain their role before offering care? Never
Did he/she ask your name and check your armband?	Did he/she ask your name and check your armband? Always	Did he/she ask your name and check your armband? Usually	Did he/she ask your name and check your armband? Sometimes	Did he/she ask your name and check your armband? Never
Did he/she clean their hands or put on gloves before drawing your blood sample?	Did he/she clean their hands or put on gloves before drawing your blood sample? Always	Did he/she clean their hands or put on gloves before drawing your blood sample? Usually	Did he/she clean their hands or put on gloves before drawing your blood sample? Sometimes	Did he/she clean their hands or put on gloves before drawing your blood sample? Never
Was the phlebotomist respectful and professional?	Was the phlebotomist respectful and professional? Always	Was the phlebotomist respectful and professional? Usually	Was the phlebotomist respectful and professional? Sometimes	Was the phlebotomist respectful and professional? Never
Was he/she sensitive to your needs?	Was he/she sensitive to your needs? Always	Was he/she sensitive to your needs? Usually	Was he/she sensitive to your needs? Sometimes	Was he/she sensitive to your needs? Never
Did he/she respect your cultural values when providing care.	Did he/she respect your cultural values when providing care. Always	Did he/she respect your cultural values when providing care. Usually	Did he/she respect your cultural values when providing care. Sometimes	Did he/she respect your cultural values when providing care. Never
Did you feel he/she respected your confidentiality?	Did you feel he/she respected your confidentiality? Always	Did you feel he/she respected your confidentiality? Usually	Did you feel he/she respected your confidentiality? Sometimes	Did you feel he/she respected your confidentiality? Never
Were you satisfied with the customer service from the laboratory today?	Were you satisfied with the customer service from the laboratory today? Always	Were you satisfied with the customer service from the laboratory today? Usually	Were you satisfied with the customer service from the laboratory today? Sometimes	Were you satisfied with the customer service from the laboratory today? Never

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* 5. The phlebotomist treated me:

1 - Very Gently

2 - Gently

3 - Somewhat Gently

4 - Roughly

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* 6. The instructions for special specimen collections were:

1 - Very Clear

2 - Somewhat Clear

3 - Somewhat Complicated

4 - Very Complicated

N/A - I didn't have special instructions

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* 7. How would you rate your overall care at the Laboratory Department?

1 - Poor

10 - Excellent

1 - Poor

10 - Excellent

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* 8. Would you recommend the Laboratory of the Sioux Lookout Meno Ya Win Health Centre to friends and family?

Definitely Yes

Probably Yes

Probably No

Definitely No

Unsure

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* 9. Please rate the Sioux Lookout Meno Ya Win Health Centre using any number from 1 - 10, where 1 is the WORST health centre possible and 10 is the BEST health centre possible

1 - Worst

10 - Best

1 - Worst

10 - Best

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* 10. Do you have any comments?

Thank you for taking the time to complete this survey. We value your opinion and we appreciate your feedback to maintain a high quality of service for our community by identifying opportunities for improvement.