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* 1. Did staff introduce themselves to you before providing care or service?

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* 2. Did you feel that you were treated with respect and dignity during your hospital visit?

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* 3. Were you or your caregiver asked what your NEEDS or CULTURAL values are when making decisions about your care?
(Your unique needs, customs, beliefs, rituals, traditions, such as any or all of the following: accessibility needs; dietary restrictions such as gluten free, vegetarian etc.; interpreter assistance for all languages; family members or close friends present; visits by clergy members, elders, or spiritual leaders; visits to the multi-denominational chapel; access to the traditional ceremonial room; traditional healing options; sacraments or sacred rituals; who you would like to make decisions about your care if not you; etc.)

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* 4. If you had any questions or concerns regarding your condition or treatment, did the nurses or doctors discuss this with you?

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* 5. Did you receive enough information from hospital staff about what to do if you were worried about your condition or treatment after you left the hospital?

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* 6. In general, how confident are you that you know what to do to take care of and manage your health?

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* 7. Did we address your anxiety and fears in a way that you felt cared for?

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* 8. Were you satisfied with the quality of food you received?

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* 9. Did you have a Miichim (Traditional Food Program) meal?

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* 10. Were you satisfied with your overall care at SLMHC?

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* 11. Would you recommend Sioux Lookout Meno Ya Win Health Centre to family and friends?

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* 12. How would you rate the Sioux Lookout Meno Ya Win Health Centre?

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* 13. Is there anyone you would like to recognize for the care he or she provided during your stay?

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* 14. Are there any general comments you would like to provide?

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* 15. Is there any feedback for improvement you would like to provide?

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