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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. Which healthcare provider did you connect with?

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* 3. Approximately how many days did you wait to connect with your healthcare provider?

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* 4. When you connect with your healthcare provider, do they involve you, as much as you want to be, in decisions about your care and treatment?

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* 5. In your most recent appointment, how did you connect with your provider? (please select all that apply)

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* 6. Was this your preferred method of contact with your provider for this type of issue?

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* 7. If no, please select your preferred method(s) of contacting your provider. (please select all that apply)

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* 8. What options of contact were provided to you when you booked your most recent appointment?

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* 9. Were there any limitations that prevented you from connecting with your provider? (please select all that apply)

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* 10. How would you rate your overall experience with the Thames Valley Family Health Team?

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* 11. Do you have any other comments you would like to share?

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* 12. In addition to patient surveys, TVFHT engages in patient feedback through townhalls, one-on-one touchpoints, and patient co-design efforts. If you are interested in participating in any of these engagement opportunities, please provide your name and preferred contact method (phone or email) in the space below.
(Alternatively, you can also leave a message at 519-473-0530, ext. 123 or email patient.experience@thamesvalleyfht.ca.)
Thank you!

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