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* 1. What was the date of your appointment?

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* 2. Who did you see today?

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* 3. If you saw a visiting specialist, what was the service?

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* 4. The staff listened to my questions and concerns.

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* 5. I felt the team members respected my privacy

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* 6. I felt the length of the appointment was...

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* 7. I felt the amount of information I received was...

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* 8. I feel that home visits are...

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* 9. I felt the transport to the clinic today was...

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* 10. The car or bus was...

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* 11. The driver was polite and helpful.

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* 12. Other comments you would like to make regarding the transport today.

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* 13. What did you like most about the care you received today at Gurriny?

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* 14. On a scale of 1 - 10, how would you rate your overall satisfaction with the care you received today? (10 stars the best, 1 star poor)

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* 15. What changes would you like to see in the way we offer our care and programs at Gurriny?

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