Patient Experience Survey - NIPIGON DISTRICT FAMILY HEALTH TEAM

Nurses, Registered Dietitian, Counsellors

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Any time you see a Family Health Team provider, how often do they involve you in decisions about your care and treatment?

	Not Applicable	Never	Rarely	Sometimes	Often	Always
Please select one of the following:	Not ApplicablePlease select one of the following: Not Applicable	NeverPlease select one of the following: Never	RarelyPlease select one of the following: Rarely	SometimesPlease select one of the following: Sometimes	OftenPlease select one of the following: Often	AlwaysPlease select one of the following: Always

Do you feel comfortable and welcome when visiting the Family Health Team?

	Not Applicable	Never	Rarely	Sometimes	Often	Always
Please select one of the following:	Not ApplicablePlease select one of the following: Not Applicable	NeverPlease select one of the following: Never	RarelyPlease select one of the following: Rarely	SometimesPlease select one of the following: Sometimes	OftenPlease select one of the following: Often	AlwaysPlease select one of the following: Always

What is your preferred method of contact? (Choose all applicable)

What method did you use to book your appointment?

Would you like to see any of the following community outreach programs? (Choose all applicable)

Other Community Outreach Program Idea

What would be your preferred time for programming?

Do you feel your health has improved since coming to the Family Health Team within the past year?

Other method see

Is there anything else you'd like to tell us?

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What is 7+4?