Patient Satisfaction Your feedback is very important to us. Please help us to improve by answering some question about the services you have received. We are interested in your honest opinions, whether positive or negative. We also welcome your comments and suggestions. Thank you very much. Please circle the option that best reflects your opinion on each of the following questions:Name First Last Email Location*West Hunt Club(Antares)Hunt ClubFindlay CreekBells CornersManotickCarleton PlaceKemptvillePerthRichmondRocklandScarborough1. How would you rate the overall quality of service you have received?*ExcellentGoodFairPoor2. How would you rate the quality of service you received from the front desk staff?*Very satisfiedMostly satisfiedIndifferentQuite dissatisfied3. How would you rate the quality of service you received from the treating therapist?*Very satisfiedMostly satisfiedIndifferentQuite dissatisfied4. To what extent has our clinic met your need?*Almost all of my needs have been metMost of my needs have been metOnly a few of my needs have been metnone of my needs have been met5. If a friend were in need of similar help, would you recommend our clinic to him or her?*Yes,definatelyYes, I think sono, I don't think soNo, definately not6. How satisfied are you with the amount of help you have received?How satisfied are you with the amount of help you have received?*Very SatisfiedMostly SatisfiedIndifferentquite dissatisfied7. If you were to seek help again, would you come back to our clinic?*Yes, definatelyYes,I think soI don't think soNo, Definately notComments PhoneThis field is for validation purposes and should be left unchanged.
