In an effort to improve our services we would appreciate you taking 10 minutes to complete our confidential patient survey. Thank you in advance!

Please select your Family Health Team

a)The last time you were sick or were concerned you had a health problem did you get an appointment on the day you wanted?

b)What was the nature of your health problem?

c)How many days did it take from when you requested an appointment with your doctor or nurse practitioner to when you actually saw him/her or someone else in the office in person or virtually?

2. In the past 12 months did you receive care virtually with your doctor or nurse practitioner?

3. If yes, please indicate how you connected (Please select all that apply)

4. Thinking about the most recent time you received care virtually, please tell us how much you agree or disagree with the following statements:

a) My health concern was addressed with the virtual visit and a follow-up appointment in person was not required.

b) Virtual care made accessing care more convenient for me.

c) Virtual care saved me time.

d) I am satisfied with the level of care I received through the virtual visit.

5. How likely are you to choose to receive care virtually again (where appropriate) when in-person visits are more available?

6. How satisfied are you with the respect and courtesy shown by the clerks, receptionists and medical secretaries at your clinic?

7. How satisfied are you with being able to communicate to your healthcare provider in your language of choice?

8. How satisfied are you with the types of wellness programs and services offered by healthcare providers (eg nurse, dietitian, social worker) at your clinic?

9. How satisfied are you with the length of time between making an appointment and actually having an in-person or virtual visit with:
a) A nurse, dietician or others at your clinic?

b) A social worker or psychologist at your clinic?

10. When you have an appointment with your doctor or nurse practitioner:
a) How often do they or someone else in the clinic involve you as much as you want in the decisions about your care and treatment?

b) Do you feel comfortable talking with them about personal problems related to your health condition?

11. Would you recommend the services of your clinic to friends or family?

What best describes your gender?



How many years have you been a patient at this clinic?

In the last 12 months, how many times did you have an appointment at this clinic?

In general how would you rate your overall health?

If you would like to provide additional feedback, please use the space below.