Client & Family Feedback Form

Do you have a compliment, concern, or suggestion about care or services at The Royal? Fill out the client and family feedback form below. Your feedback will help us improve the client and family experience.

All submissions to this feedback form will be shared with our Client & Family Relations team for review and follow-up. Please be sure to include your contact information if you wish to be contacted for follow-up.

Would you prefer to get in touch with the Client & Family Relations team directly? Here is their contact information:

Jonathan Vant - Manager of Client & Family Relations
- Phone: 613.722.6521 ext. 6710
- Email: Jonathan.Vant@theroyal.ca
- Office: Room 1207, The Royal (1145 Carling Ave., Ottawa ON)

Leticia Hardowar - Family Experience & Engagement Coordinator
- Phone: 613.722.6521 ext. 6557
- Email: Leticia.Hardowar@theroyal.ca
- Office: Room 1208, The Royal (1145 Carling Ave., Ottawa ON)

You may also choose to discuss your feedback directly with your care team.

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* 1. Happy with your care? Tell us what we did well:

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* 2. Any suggestions? Please share any suggestions for improvement:

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* 3. Unhappy with your care? Please tell us about your concerns:

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* 4. Resolution: If you have shared a concern, how would you like it to be resolved?

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* 5. Contact information (optional): If you would like to receive a follow-up, please leave your name, phone number and/or email address.

Name

Phone number

Email address

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* 6. Program/unit/area of service (this information is very important to help us make the necessary quality improvements)

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* 7. Are you an inpatient, outpatient, friend or family member?

Inpatient

Outpatient

Friend

Family member

Other (please specify)