Patient Experience Survey

Thank you for taking the time to answer this short survey about your care as a patient at this practice. Please note that your answers will be kept confidential. Your name will not be collected. It will not be possible to identify who completed a survey and who did not.

Please identify the location(s) where you have received services from the Thames Valley Family Health Team.

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* 1. Please identify the location(s) where you have received services from the Thames Valley Family Health Team.

Ilderton Medical Clinic (36 Heritage Drive, Ilderton)

London - Byron Family Medical Centre (1228 Commissioners Road West, London)

London - Dr. G. Persaud (279 Wharncliffe Road North, London)

London - Forest City Family Health Organization (450 Central Avenue, London)

London - Oxford Medical Centre (Chelsey Park, London)

London - Springbank Medical Centre (460 Springbank Drive, London)

London - St. Joseph's Family Medical Centre (346 Platt's Lane)

London - Victoria Family Medical Centre (60 Chesley Avenue, London)

London - West London Family Health Centre (Westmount Mall, London)

London - Westmount Family Physicians (Westmount Mall, London)

London - Whitehills Family Medical Centre (Sherwood Forest Mall, London)

Mount Brydges - Southwest Middlesex Health Centre (22262 Mill Road, Mount Brydges)

St. Thomas - Elmwood Family Health Centre (204 First Ave, St. Thomas)

St. Thomas - Windemere Family Medical Centre (460 Wellington Street, St. Thomas)

Strathroy Family Health Organization (31 Caradoc Street North, Strathroy OR Main Street, Ailsa Craig)

Strathroy Medical Clinic (74 Front Street East, Strathroy)

Woodstock Family Health Team (12 Perry Street OR 729 Devonshire Ave, Woodstock)

Woodstock Family Health Team (959 Dundas Street OR 600 Princess Street, Woodstock)

Unsure

Did you see:

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* 2. Did you see:

My family doctor

Another doctor in the same building, or a medical resident or student

Nurse practitioner

Registered nurse

Registered dietitian

Social worker

Pharmacist

Psychologist

Occupational therapist

Respiratory therapist

Don't know or don't remember

Based on the many healthcare providers listed above, were you aware that you could access these providers through the Thames Valley Family Health Team?

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* 3. Based on the many healthcare providers listed above, were you aware that you could access these providers through the Thames Valley Family Health Team?

Yes

The last time you were sick or concerned you had a health problem, how many days did it take from when you first tried to see your healthcare provider to when you actually saw him/her or someone else in the office?

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* 4. The last time you were sick or concerned you had a health problem, how many days did it take from when you first tried to see your healthcare provider to when you actually saw him/her or someone else in the office?

Same day

Next day

2 - 19 days

20 or more days

Don't know or don't want to say

Was it easy for you to schedule an appointment?

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* 5. Was it easy for you to schedule an appointment?

Very easy

Easy

Manageable

Difficult

If difficult, please tell us why:

Based on your most recent visit, please check the response that best matches your opinion:

When you see your healthcare provider, do they involve you as much as you want to be in decisions about your care or treatment?

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* 6. When you see your healthcare provider, do they involve you as much as you want to be in decisions about your care or treatment?

Always

Often

Sometimes

Rarely

Never

Did you find the facility welcoming, non-discriminating and comfortable (for example, the entrance, waiting room, decor, posters, or exam room)?

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* 7. Did you find the facility welcoming, non-discriminating and comfortable (for example, the entrance, waiting room, decor, posters, or exam room)?

Yes

If no, please tell us why

Were staff sensitive to your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

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* 8. Were staff sensitive to your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

Yes

If no, please tell us why

Did the services provided meet your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

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* 9. Did the services provided meet your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

Yes

If no, please tell us why

Overall, how would you rate our services to you and your family?

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* 10. Overall, how would you rate our services to you and your family?

Excellent

Good

Fair

Poor

Comments:

Thinking of your overall experience with our clinic, what are...?

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* 11. Thinking of your overall experience with our clinic, what are...?

Two things done particularly well:
1.

Two things that could be improved:
1.

Is there any additional information or feedback you would like to share with us that could help us improve the way we provide care?

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* 1. Please identify the location(s) where you have received services from the Thames Valley Family Health Team.

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* 2. Did you see:

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* 3. Based on the many healthcare providers listed above, were you aware that you could access these providers through the Thames Valley Family Health Team?

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* 4. The last time you were sick or concerned you had a health problem, how many days did it take from when you first tried to see your healthcare provider to when you actually saw him/her or someone else in the office?

Question Title

* 5. Was it easy for you to schedule an appointment?

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* 6. When you see your healthcare provider, do they involve you as much as you want to be in decisions about your care or treatment?

Question Title

* 7. Did you find the facility welcoming, non-discriminating and comfortable (for example, the entrance, waiting room, decor, posters, or exam room)?

Question Title

* 8. Were staff sensitive to your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

Question Title

* 9. Did the services provided meet your individual needs (for example, religion, language, accessibility needs, sexual orientation, ethnic background, gender, race, etc.)?

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* 10. Overall, how would you rate our services to you and your family?

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* 11. Thinking of your overall experience with our clinic, what are...?

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* 12. Is there any additional information or feedback you would like to share with us that could help us improve the way we provide care?