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Patient Experience Survey 2021

Thank you for being a patient of Summerville Family Health Team. We are very interested in your feedback on our services, which will help us achieve our goal of providing patient-centred, high quality, integrated and accessible care. 

Please take a few moments of your time to complete our annual patient survey by checking or circling the most appropriate response. Your responses will be kept completely confidential and will help us to improve our services and plan for the future.

ABOUT YOU
Gender
Female  Male  Prefer not to say  Prefer to self-describe  
Gender (description)
Age
18 to 24  
25 to 34  
35 to 44  
45 to 54  
55 to 64  
65 to 74  
75 or older  
Indigenous Identity
          
Were you born in Canada?
Yes  No  Prefer not to answer  Do not know  
What year did you arrive in Canada?
Language First Spoken at Home
English
French
Other, please specify