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Memory Clinic Survey
Please indicate a response to each of the following statements.
OK
1.
What month did your memory clinic appointment take place?
July 2021
August 2021
September 2021
October 2021
November 2021
December 2021
January 2022
February 2022
March 2022
April 2022
May 2022
June 2022
July 2022
2.
I was able to get an appointment in good time.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
3.
My concerns and questions were adequately addressed.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
4.
I was satisfied with the amount of time the memory clinic team spent with me.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
5.
I have a better understanding about the symptoms/condition as a result of my visit.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
6.
I would recommend this clinic to others who have similar concerns.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
7.
This visit to the Memory Clinic was a valuable addition to the regular care provided by my family doctor.
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
8.
I am a Memory Clinic
Patient
Caregiver/Family/Friend
9.
Overall, how satisfied were you with your visit?
Extremely dissatisfied
Very dissatisfied
Somewhat satisfied
Neither satisfied nor dissatisfied
Somewhat satisfied
Very satisfied
Extremely satisfied
10.
Do you have any comments you would like to make about your memory clinic visit?
11.
Is there anything we can do better?
Current Progress,
0 of 11 answered