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Mental Health and Addictions Client Experience Survey
1.
Please tell us who is completing the survey:
Client
Parent/Guardian
Caregiver
Spouse/Partner
Escort
Other
Client
Parent/Guardian
Caregiver
Spouse/Partner
Escort
Other
2.
Did staff introduce themselves to you before providing care?
Yes, always
Yes, Sometimes
No
Yes, always
Yes, Sometimes
No
3.
Did you feel that you were treated with respect and dignity during your visit to the Mental Health and Addictions Program?
Yes, always
Yes, sometimes
No
4.
Did staff take your cultural values or personal preferences and those of your family or caregiver into account when making decisions about your care?
These things may include, but not limited to, accessibility needs, interpreter assistance, visits by clergy, elders, or spiritual leaders.
Yes, always
Yes, sometimes
No
If no, please tell us what we can do better.
5.
Did you receive enough information from MHAP staff about what to do if you were worried about your mental health/addictions needs after you were finished receiving care at MHAP?
Yes, always
Yes, sometimes
No
6.
In general, how confident are you that you know what to do to take care of and manage your substance use and/or mental health?
Very confident
Somewhat confident
Not confident at all
7.
Did staff address your anxiety and fears in a way that you felt cared for?
Yes, Always
Yes, Sometimes
Never
Yes, Always
Yes, Sometimes
Never
8.
Do you feel that coming to the Mental Health and Addictions Program helped you?
Yes
No
Not Sure
Yes
No
Not Sure
9.
What topics did you find helpful during your visit?
10.
Would you recommend the Mental Health and Addictions Program at SLMHC to family and friends based on the quality of care provided?
Yes, always
Yes, somewhat
No
11.
Please rate Sioux Lookout Meno Ya Win Health Centre with a number from 1 - 10, with 10 being the best health centre possible and 1 being the worst health centre possible.
1 - Worst Hospital
2
3
4
5
6
7
8
9
10 - Best Hospital
1 - Worst Hospital
2
3
4
5
6
7
8
9
10 - Best Hospital
12.
Is there anyone you would like to recognize for the care he or she provided?
No
Yes
If yes, please tell us whom you would like to recognize and why.
13.
Are there any general comments or feedback for improvement you would like to share?
14.
Would you like to be contacted about the information you provided in this survey?
Yes
No
If yes, please provide your name and preferred contact method below (phone number or email address).
15.
Would you like to add your name to a list of clients to be contacted for input on future SLMHC projects/changes?
Yes
No
If yes, please provide your name and preferred contact method below (phone number or email address).
If you would like to provide additional feedback, please ask any staff member for a Compliment/Feedback Form.
