In order to support you in achieving your best possible health and wellbeing, we need to know what you think about the services you’ve received within the past year, the people who provided it, and the results. Please answer all the questions. Your answers will be kept private. Comments you make in this survey may be used in a summary report but will be kept anonymous. Your honest opinion will help us make our services better!

Please answer questions 1-4 if you come to the CKCHC for appointments with a Doctor or Nurse Practitioner.

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* 1. I am a client at the...

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* 2. The last time you were sick or were concerned you had a health problem, 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?

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* 3. If 2-19 days how many days?

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* 4. 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?

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* 5. 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?

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

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