Patient Feedback

This survey is for patients of the Vitallife Centre for Integrative Medicine. Please answer all questions to the best of your knowledge.

Please provide your contact information. All fields are optional.

Contact Information
  1. (required)
  2. (valid email required)
Questionnaire
  1. How did you hear about Dr. Cheryl Cooper ND? (If appropriate, please specify details.)||
  2. How easy was it for you to book an appointment?
  3. Did you receive your intake forms in a timely manner?
  4. Did the intake forms enable you to effectively outline your health concerns?
  5. Were you able to book an appointment at a time that was convenient for you?
  6. Were you greeted and made to feel welcome upon your arrival to the office?
  7. Have your appointments started on time?
  8. Did Dr. Cooper provide you with an effective treatment plan?
  9. Did Dr. Cooper provide you with information that was helpful to address your health concerns?
  10. Was the information provided in your visit(s) valuable?
  11. Effective explanation of your health evaluation
  12. Effective explanation of test results
  13. Effective explanation of supplements
  14. Explanation of other recommendations
  15. Handouts||
  16. Please rate your satisfaction in the following areas: (1 being poor, 5 being excellent):
  17. Answers to your medical questions
  18. Value of the information you received
  19. Overall care
  20. Receiving correspondence in a timely manner
  21. Timing for reporting of results
  22. When your appointment was over, did you have a better understanding of your health concerns?
  23. Would you recommend your practitioner to a friend, relative or colleague?
 

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Thank you for enabling us to provide better care for you and our other patients.