Patient Survey | Canadian Vascular Laboratories

We care about your opinion, your feedback allows us to continually improve our service,

Fields marked with a * are required.

	Poor	Fair	Good	Very Good	Excellent	No Opinion
Please rate how long you had to wait to get an appointment at this clinic.*
Please rate how long your wait in the waiting room was before you were seen.*
Please rate how clearly your preparations and risks of the tests were explained to you.*
Please rate the level of concern, care, respect, friendliness and kindness you were given.*
Please rate how clear the instructions you received were on what to do and what to expect after you have left the clinic.*
Please rate how likely you are to recommend this clinic to a friend or family member if they need the services of this clinic.*
How would you rate the services and the treatment you received at this clinic.*

Name:

Email:

Location:*

Date Visited:*

What suggestions or changes would you recommend to improve our service?

* Security question: What is 12 - 7?*

PATIENT FEEDBACK FORM