Questionnaire

Thank you for attending The Shoulder Centre appointment today. The Centre would like to collect additional information from each patient to support ongoing service delivery improvement, increase quality in care provided and ensure patient satisfaction. Kindly provide your responses to the questions listed below.

A) The following questions are related to the health concerns being addressed in today’s appointment:

B) Would you allow The Shoulder Centre to include your clinical results in ongoing education materials (please note, your personal identifying information will not be included, only clinical results)

C) How did you hear about The Shoulder Centre?

D) Would you allow The Shoulder Centre to email you a survey to collect feedback on the care you have received?