Patient & Family Experience Survey - We Value Your Feedback

The Patient Experience Feedback process provides patients and their family members with an opportunity to express compliments or discuss questions or concerns. We encourage patients and family members to provide feedback so that we can better understand your care experience. 
If you have a concern regarding your visit please call the Patient Experience Office directly 519-272-8210 Ext. 2737 to ensure prompt action.
 
All responses collected are kept private and confidential.

The hospital is committed to accessibility for persons with disabilities. If you require help filling out this survey please contact the Patient Relations/Patient Experience office of the hospital you visited.
Date of visit

Question Title

* 1. Date of visit

Date / Time
Type of Feedback

Question Title

* 2. Type of Feedback

T