Facility - None -Campbellton Regional HospitalChaleur Regional HospitalDr. Georges-L.-Dumont University Hospital CentreEdmundston Regional HospitalEnfant-Jésus RHSJ† HospitalGrand Falls General HospitalHôtel-Dieu Saint-Joseph de Saint-QuentinLamèque Hospital and Community Health CentreRestigouche Hospital CentreStella-Maris-de-Kent HospitalTracadie-Sheila HospitalSt. Joseph Community Health CentreSaint-Isidore Community Health CentreChaleur Health CentreJacquet River Health CentreMiscou Health CentrePaquetville Health CentreSainte-Anne Health CentreShediac Regional Medical CentreE. L. Murray Medical ClinicHaut-Madawaska Medical ClinicKedgwick Medical ClinicDieppe Phlebotomy ClinicPublic Health, Bathurst officePublic Health, Campbellton officePublic Health, Caraquet officePublic Health, Edmundston officePublic Health, Grand Falls officePublic Health, Kedgwick officePublic Health, Moncton officePublic Health, Richibucto officePublic Health, Sackville officePublic Health, Shediac officePublic Health, Shippagan officePublic Health, Tracadie-Sheila office Department Date Are you satisfied with the length of time you had to wait for your appointment? Yes, definitely Yes, to some extent No Were you able to choose an appointment time (day/hour) that fit your schedule? Yes, definitely Yes, to some extent No The day of your appointment, how long did you have to wait before being registered? I did not have to wait Less than 15 mins 15-30 mins 31-60 mins More than 1 hour Not applicable How long after the scheduled appointment time did your appointment start? Seen on time, or earlier Waited less than 15 mins Waited 15-30 mins Waited 31-60 mins Waited more than 1 hour Did the staff treat you with courtesy and respect? Yes, definitely Yes, to some extent No Did the staff introduce themselves, by stating their name and role, before providing care or treatments? Yes, always Yes, sometimes Never Was your privacy respected by staff during care or treatments (e.g. closed the door, pulled the curtain)? Yes, definitely Yes, to some extent No During your appointment/treatment, did the staff explain things in a way you could understand? Yes, definitely Yes, to some extent No I did not need explanations / Not applicable Were you involved as much as you wanted to be in decisions about your care/treatments? Yes, definitely Yes, to some extent No I was not well enough to be involved Did you receive help from the staff, if needed? Yes, always Yes, sometimes No A staff member was with me all the time I did not need help / Not applicable In your opinion, how clean were the rooms? Very clean Fairly clean Not very clean Not at all clean Did you notice if staff washed or disinfected their hands before caring for you? Yes, always Yes, sometimes Never I did not notice I did not see any facilities for washing/disinfecting hands Did staff check your identity (e.g. name, date of birth, bracelet) before giving you medication or treatments? Yes, always Yes, sometimes No I do not remember Before giving you a medication, did the staff tell you what it was for? Yes, always Yes, sometimes Never I was not given any medication / Not applicable Before leaving, did the staff explain the reason for, and possible side effects of, newly prescribed medications? Yes, completely Yes, to some extent No I was not prescribed any new medication / Not applicable Did a staff member talk to you about things to watch for regarding your illness or treatment after you went home? Yes, completely Yes, to some extent No No, I did not need this information / Not applicable Was the written information you received about your health problem or treatment easy to understand? Yes, definitely Yes, to some extent No I did not receive information but I would have liked some Not applicable Did a staff member tell you who to call if you had questions about your health problem or your treatment after you went home? Yes No Not applicable How often did you receive the service you needed in the official language (English or French) of your choice? Always Usually Sometimes Never Overall, how was your experience during this visit? 0 is the worst experience and 10 is the best experience 1 2 3 4 5 6 7 8 9 10 Comments: Optional Name Telephone Thank you for taking the time to complete this survey!