Patient and Family Experience Survey

Thank you for taking the time to tell us about your experience while receiving care at the hospital. Should you like to discuss your experience more, please email us at patientfamily@nbrhc.on.ca.

Question Title

* 1. I was/am a:

Patient

Family/Friend

Other (please specify)

Question Title

* 2. Date of care:

Please enter the date

Date

Question Title

* 3. What type of care did you receive:

Inpatient (admitted to the hospital overnight) or Clinics (provided with hands on treatment or procedure)

Community Based or Outpatient Clinics (not providing hands on treatment or procedure)

Other (if not sure or would like to share general feedback)