You are being invited to take part in this survey if you have recently had a visit at Wawa Family Health Team. Your responses to the questions on this survey will help us improve the care we provide. There are six sections of the survey and it will take approximately 5 minutes to complete.

 

Participation in the survey is completely voluntary and all your responses to the survey questions will be kept confidential.

* 1. Section One:  Contacting Us
 How was the appointment for your most recent visit made?

* 2. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
The length of time it took between making your appointment and the visit you just had

* 3. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
Your overall experience accessing the office/clinic

* 4. Section Two:  Arriving and Waiting at the Office/Clinic
Still thinking about your most recent visit; on a scale of poor to excellent, how would you rate the following?
The length of time you had to wait in the reception/waiting area

* 5. Still thinking about your most recent visit; on a scale of poor to excellent, how would you rate the following?
Your overall experience with our reception staff

* 6. Section 3:  Your Appointment
Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They knew about your medical history

* 7. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They listened to your concerns

* 8. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They spoke using a language you could understand

* 9. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They explained things in a way that was easy to understand

* 10. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They were sensitive to your needs and preferences

* 11. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They treated you with dignity and respect

* 12. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
They gave you clear instructions about what you needed to do after your visit

* 13. Still thinking about your most recent visit and the MAIN health care provider you spoke with during the visit; on a scale of poor to excellent, how would you rate the following?
Your overall experience speaking with the health care provider about the reason for your visit

* 14. Section 4:  Your Overall Experience with your Most Recent Visit
Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
The overall cleanliness of the office/clinic

* 15. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
The overall physical comfort of the office/clinic

* 16. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
Your confidence in the doctor/health care provider(s) you saw during the visit

* 17. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
Your confidence that your health information was treated with the level of privacy you expect

* 18. Thinking about your most recent visit, on a scale of poor to excellent, how would you rate the following?
Your overall experience with the visit you had with us

* 19. Section Five:  Your Experiences Visiting with us Over the Last Year or So
The first couple of questions below are similar to the ones asked earlier.  However, instead of thinking about your most recent visit, we`d like you to think more broadly about your experiences with us OVER THE LAST YEAR OR SO.
The last time you were sick or were concerned you had a health problem, did you get an appointment on the date you wanted?

* 20. How many days did it take from when you first tried to see your doctor or nurse practitioner to when you actually saw him/her or someone else in their office?

* 21. When you see your doctor or nurse practitioner, how often do they or someone else in the office give you an opportunity to ask questions about recommended treatment?

* 22. When you see your doctor or nurse practitioner, how often do they or someone else in the office involve you as much as you want to be in decisions about your care and treatment?

* 23. When you see your doctor or nurse practitioner, how often do they or someone else in the office spend enough time with you?

* 24. Section 6:  Context/Demographics
In general, how would you rate your overall health?

* 25. How long have you been visiting us for your health care?

* 26. Using your best guess, how many times did you visit us over the last year or so for your own medical care

* 27. Would you recommend our services to your family or friends?  Check ONE only.

* 28. Feedback (optional)
Thinking of your overall experience with our office/clinic, what are two things done particularly well?

* 29. Thinking of your overall experience with our office/clinic, what are two things that could be improved?

* 30. Is there any additional information or feedback you would like to share with us that could help us improve the way we provide care?

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