Kaymar Patient/Caregiver Survey

Patient Feedback Survey

We welcome your feedback! The responses you provide will help us improve the care we deliver.
The services(s) you received from Kaymar Rehabilitation:

Occupational TherapySpeech Language PathologySocial WorkNutrition (Registered Dietitian)PhysiotherapyRehabilitation Assistant
The name of your therapist(s)
I received service in the language of my choice.

YesNo

Overall satisfaction of service

	Strongly Agree	Agree	Neutral	Disagree	Strongly Disagree	Don't Know	Doesn't Apply
The home care I received was what I needed.
My therapist knew my medical history.
My therapist explained things in a way that was easy to understand.
I was involved in decisions about my treatment as much as I wanted to be.
I knew who to call if I needed information.
I felt physically and emotionally safe during my care.
My therapist treated me with courtesy and respect.
My therapist supported my main caregiver at home as much as they needed.
I benefited from the service.
I benefited from the Virtual Care (phone calls and/or video calls) I received (if applicable).
I made more significant gains working with the Rehabilitation Assistant (if applicable).

Positive Comments:
Suggestions for Improvement:
If you have any concerns or would like more information about this survey, please contact us via our website www.kaymar.ca or at (613) 542-8739. If you would like to be more involved in providing feedback about other aspects of our service (e.g., Virtual care, the Kaymar booklet, website, etc.) please provide your contact information below.
If you wish to be contacted:
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Should be Empty:

Patient Feedback Survey