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Your Experience Matters

Please complete this short survey to let us know how we did today! Your participation in this survey is voluntary and anonymous. Thank you.
1.Did staff confirm who you are, using at least two of the following identifiers?

• Your full name

• Your home address

• Your date of birth

• Your provincial health card
2.Did you see a staff member clean their hands before physical contact with you?
3.Did you receive clear information on your plan of care and follow-up appointments?
4.Rate your overall experience in our clinic today.
We Value Your Voice – Help Us Improve Your Care!
Would you like to make a difference in how we provide care to patients? We invite you to join our Ambulatory Care Quality Committee and share your thoughts and experiences to help us improve services.

If you're interested in being contacted, please provide your name and phone.
5.Name
6.Phone number
We’d also love to hear any suggestions you have to enhance our services.

Please let us know which clinic you visited and any feedback you’d like to share
7.Clinic
8.Comments
Thank you for helping us serve you better!