Patient Experience and Satisfaction Survey

We kindly ask you to complete this survey to share feedback on your experience and satisfaction with the care you received from a CommuniCare Therapy therapist.

The responses you provide will help us improve the care we provide. The survey responses you provide are anonymous and not tracked in any way. Your participation in this survey is voluntary.

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* 1. What service did you receive?

Occupational Therapy

Physiotherapy

Speech Language Pathology

Dietetics

Social Work

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* 2. If you recall the name of your therapist, please indicate it below.

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* 3. Did the therapist arrange for visits at a time that was agreeable to you?

Almost always

Often

Sometimes

Rarely

Never

Cannot recall

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* 4. Was the therapist on time for the visits (+/- 15 minutes)?

Most of the time

Some of the time

Rarely

Never

Cannot recall

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* 5. Did you have any virtual visits?

Yes, over the phone

Yes, using video calls or Zoom

No all care was in person

I’m not sure

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* 6. Did the therapist treat you with courtesy and respect?

Yes

Sometimes

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* 7. Did the therapist allow you to ask questions or share your concerns?

Always

Very Often

Sometimes

Rarely

Never

Cannot recall

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* 8. Did the therapist listen carefully to you?

Always

Very Often

Sometimes

Rarely

Never

Cannot recall

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* 9. Did the therapist explain things in a way that you could understand?

Yes

Sometimes

Cannot recall

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* 10. Did you feel that the therapist prioritized your safety?

Yes

Sometimes

Cannot recall

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* 11. Did you receive services in the official language of your choice (French or English)?

Yes

Sometimes

Cannot recall

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* 12. Did the therapist ask for your input when determining your therapy goals and plan?

Yes

Cannot recall

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* 13. How would you rate the therapy recommendations, information, or resources the therapist shared with you?

Very Helpful

Somewhat Helpful

Not Helpful

No opinion

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* 14. Did the therapist provide their recommendations, information, or resources to you in your preferred method? (Select all that apply)

Yes in writing

Yes electronically

Cannot recall

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* 15. At the start of service did the therapist explain what services would be provided and the criteria for the end of service (discharge)?

Yes

Cannot recall

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* 16. If you requested it did the therapist include family or friends in decisions about your care as much as you wanted?

Yes

Somewhat

Not applicable – I did not ask for others to be included

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* 17. Did the therapist provide services according to the schedule and plan developed with you?

Yes

Cannot recall

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* 18. Did you improve and function better following treatment or by following the recommendations provided?

To a great extent

Somewhat

Very little

Not at all

No opinion

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* 19. At the end of services did the therapist explain or provide information on how you can continue to improve or maintain your progress?

Yes

Cannot recall

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* 20. Overall how satisfied are you with care you received from your CommuniCare Therapy therapist?

Very Satisfied

Satisfied

Neutral

Unsatisfied

Very Unsatisfied

About You - the next questions are to help us understand the community we serve.

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* 21. What Home and Community Care region are you located in?

Champlain (Ottawa, Eastern Counties, North Lanark North Grenville)

South East (Leeds, Lanark, Grenville)

Unsure

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* 22. Are any of the items below a struggle for you? (Select all that apply)

Physical Health

Mental/Emotional Health

Finances

Prefer not to say

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* 23. What is the highest level of school you have attended?

Prefer not to say

Elementary school

High school

College, Vocational/Technical school or University

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* 24. If you identify with a minority group(s) please identify it below. (Select all that apply)

Not Applicable

Prefer not to say

2SLGBTQI+

Race

Ethnicity

First Nations, Inuit or Métis

Person with Disabilities

Language

Religion

I Self-Identify (please specify self-identification below):

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* 25. If there was something specific your therapist did that was a benefit to you and key to your satisfaction, would you please share the details below?

Patient Experience and Satisfaction Survey

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* 1. What service did you receive?

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* 2. If you recall the name of your therapist, please indicate it below.

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* 3. Did the therapist arrange for visits at a time that was agreeable to you?

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* 4. Was the therapist on time for the visits (+/- 15 minutes)?

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* 5. Did you have any virtual visits?

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* 6. Did the therapist treat you with courtesy and respect?

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* 7. Did the therapist allow you to ask questions or share your concerns?

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* 8. Did the therapist listen carefully to you?

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* 9. Did the therapist explain things in a way that you could understand?

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* 10. Did you feel that the therapist prioritized your safety?

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* 11. Did you receive services in the official language of your choice (French or English)?

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* 12. Did the therapist ask for your input when determining your therapy goals and plan?

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* 13. How would you rate the therapy recommendations, information, or resources the therapist shared with you?

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* 14. Did the therapist provide their recommendations, information, or resources to you in your preferred method? (Select all that apply)

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* 15. At the start of service did the therapist explain what services would be provided and the criteria for the end of service (discharge)?

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* 16. If you requested it did the therapist include family or friends in decisions about your care as much as you wanted?

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* 17. Did the therapist provide services according to the schedule and plan developed with you?

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* 18. Did you improve and function better following treatment or by following the recommendations provided?

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* 19. At the end of services did the therapist explain or provide information on how you can continue to improve or maintain your progress?

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* 20. Overall how satisfied are you with care you received from your CommuniCare Therapy therapist?

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* 21. What Home and Community Care region are you located in?

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* 22. Are any of the items below a struggle for you? (Select all that apply)

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* 23. What is the highest level of school you have attended?

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* 24. If you identify with a minority group(s) please identify it below. (Select all that apply)

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* 25. If there was something specific your therapist did that was a benefit to you and key to your satisfaction, would you please share the details below?

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* 26. If you have anything else to share please use the space below.