Client Experience Survey 2022

Question Title

* 1. Which location do you primarily go to for services?

Vaughan site

Keswick site

Question Title

* 2. Which services are you currently receiving in person or virtually (video conference, telephone) at the Vaughan CHC? (Please select all that apply)

	Did you receive the service virtually?	Did you receive the service in-person?	Did the appointment or program meet your healthcare needs?
Primary Care (Family Physician & Nurse Practitioner)	Primary Care (Family Physician & Nurse Practitioner) Did you receive the service virtually?	Primary Care (Family Physician & Nurse Practitioner) Did you receive the service in-person?	Primary Care (Family Physician & Nurse Practitioner) Did the appointment or program meet your healthcare needs?
Mental Health Counselling	Mental Health Counselling Did you receive the service virtually?	Mental Health Counselling Did you receive the service in-person?	Mental Health Counselling Did the appointment or program meet your healthcare needs?
Nutritional Counselling	Nutritional Counselling Did you receive the service virtually?	Nutritional Counselling Did you receive the service in-person?	Nutritional Counselling Did the appointment or program meet your healthcare needs?
Physiotherapy	Physiotherapy Did you receive the service virtually?	Physiotherapy Did you receive the service in-person?	Physiotherapy Did the appointment or program meet your healthcare needs?
Foot Care	Foot Care Did you receive the service virtually?	Foot Care Did you receive the service in-person?	Foot Care Did the appointment or program meet your healthcare needs?
Diabetes Education Program	Diabetes Education Program Did you receive the service virtually?	Diabetes Education Program Did you receive the service in-person?	Diabetes Education Program Did the appointment or program meet your healthcare needs?
Chronic Obstructive Pulmonary Disease (COPD) / Lung Health/ Smoking Cessation	Chronic Obstructive Pulmonary Disease (COPD) / Lung Health/ Smoking Cessation Did you receive the service virtually?	Chronic Obstructive Pulmonary Disease (COPD) / Lung Health/ Smoking Cessation Did you receive the service in-person?	Chronic Obstructive Pulmonary Disease (COPD) / Lung Health/ Smoking Cessation Did the appointment or program meet your healthcare needs?
System Navigation Case Management	System Navigation Case Management Did you receive the service virtually?	System Navigation Case Management Did you receive the service in-person?	System Navigation Case Management Did the appointment or program meet your healthcare needs?
Health Promotion Group Program (including exercise programs)	Health Promotion Group Program (including exercise programs) Did you receive the service virtually?	Health Promotion Group Program (including exercise programs) Did you receive the service in-person?	Health Promotion Group Program (including exercise programs) Did the appointment or program meet your healthcare needs?

Comments

Question Title

* 3. Are there limitations that prevent you from connecting with your provider virtually (please select all that apply)

No access to a computer/laptop/tablet

Not knowing how to use a computer/laptop

No privacy at home

Have a disability and need support with technology

No limitations

Other (please specify)

Question Title

* 4. Thinking about your most recent individual appointment, on a scale of 1-10 , one being poor and ten being excellent, how would you rate the following?

	1	2	3	4	5	6	7	8	9	10
Length of time it took between making your appointment and the visit you just had	Length of time it took between making your appointment and the visit you just had 1	Length of time it took between making your appointment and the visit you just had 2	Length of time it took between making your appointment and the visit you just had 3	Length of time it took between making your appointment and the visit you just had 4	Length of time it took between making your appointment and the visit you just had 5	Length of time it took between making your appointment and the visit you just had 6	Length of time it took between making your appointment and the visit you just had 7	Length of time it took between making your appointment and the visit you just had 8	Length of time it took between making your appointment and the visit you just had 9	Length of time it took between making your appointment and the visit you just had 10
Your overall experience with the visit	Your overall experience with the visit 1	Your overall experience with the visit 2	Your overall experience with the visit 3	Your overall experience with the visit 4	Your overall experience with the visit 5	Your overall experience with the visit 6	Your overall experience with the visit 7	Your overall experience with the visit 8	Your overall experience with the visit 9	Your overall experience with the visit 10

Question Title

* 5. Thinking about the MAIN health care provider you spoke with during the visit, on a scale of 1-10 , one being poor and ten being excellent, how would you rate the following?

	1	2	3	4	5	6	7	8	9	10
I was offered services in a language I understand and or was offered interpretation services	I was offered services in a language I understand and or was offered interpretation services 1	I was offered services in a language I understand and or was offered interpretation services 2	I was offered services in a language I understand and or was offered interpretation services 3	I was offered services in a language I understand and or was offered interpretation services 4	I was offered services in a language I understand and or was offered interpretation services 5	I was offered services in a language I understand and or was offered interpretation services 6	I was offered services in a language I understand and or was offered interpretation services 7	I was offered services in a language I understand and or was offered interpretation services 8	I was offered services in a language I understand and or was offered interpretation services 9	I was offered services in a language I understand and or was offered interpretation services 10
I was treated with dignity and respect	I was treated with dignity and respect 1	I was treated with dignity and respect 2	I was treated with dignity and respect 3	I was treated with dignity and respect 4	I was treated with dignity and respect 5	I was treated with dignity and respect 6	I was treated with dignity and respect 7	I was treated with dignity and respect 8	I was treated with dignity and respect 9	I was treated with dignity and respect 10
I was provided with clear information and given an opportunity to ask questions about recommended treatment	I was provided with clear information and given an opportunity to ask questions about recommended treatment 1	I was provided with clear information and given an opportunity to ask questions about recommended treatment 2	I was provided with clear information and given an opportunity to ask questions about recommended treatment 3	I was provided with clear information and given an opportunity to ask questions about recommended treatment 4	I was provided with clear information and given an opportunity to ask questions about recommended treatment 5	I was provided with clear information and given an opportunity to ask questions about recommended treatment 6	I was provided with clear information and given an opportunity to ask questions about recommended treatment 7	I was provided with clear information and given an opportunity to ask questions about recommended treatment 8	I was provided with clear information and given an opportunity to ask questions about recommended treatment 9	I was provided with clear information and given an opportunity to ask questions about recommended treatment 10

Question Title

* 6. When attending group programs, do you feel connected and involved in the program?

Always

Often

Sometimes

Rarely

Never

Not applicable

Question Title

* 7. Do you feel comfortable and welcome at the Vaughan Community Health Centre?

Yes

If no, please tell us the reason why not

Question Title

* 8. How long have you been a client of Vaughan CHC? (have attended an individual appointment or group programs)

Less than 6 months

Between 6 months and a year

Between 1 year and 3 years

Between 3 and 5 years

Longer than 5 years

Question Title

* 9. Since January 2022 to now, how many times did you visit VCHC (in-person or virtual) for an appointment or to attend a group program?

One

Two

Three

Four

Five or more

Question Title

* 10. Please check one of the age group(s) below that applies to you.

13-18

19-29

30-39

40-54

55-64

65+ years

Question Title

* 11. Self- Identified gender:

Female

Male

Intersex

Transgender (Female to Male)

Transgender (Male to Female)

Two-Spirit

Do not know

Prefer not to answer

Other

Client Experience Survey 2022

Question Title

* 1. Which location do you primarily go to for services?

Question Title

* 2. Which services are you currently receiving in person or virtually (video conference, telephone) at the Vaughan CHC? (Please select all that apply)

Question Title

* 3. Are there limitations that prevent you from connecting with your provider virtually (please select all that apply)

Question Title

* 4. Thinking about your most recent individual appointment, on a scale of 1-10 , one being poor and ten being excellent, how would you rate the following?

Question Title

* 5. Thinking about the MAIN health care provider you spoke with during the visit, on a scale of 1-10 , one being poor and ten being excellent, how would you rate the following?

Question Title

* 6. When attending group programs, do you feel connected and involved in the program?

Question Title

* 7. Do you feel comfortable and welcome at the Vaughan Community Health Centre?

Question Title

* 8. How long have you been a client of Vaughan CHC? (have attended an individual appointment or group programs)

Question Title

* 9. Since January 2022 to now, how many times did you visit VCHC (in-person or virtual) for an appointment or to attend a group program?

Question Title

* 10. Please check one of the age group(s) below that applies to you.

Question Title

* 11. Self- Identified gender:

Question Title

* 12. Do you have any other questions or comments that you would like to share?