Diabetes Survey

Diabetes & Chronic Disease Management Satisfaction Survey

Diabetes Survey
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I understand my answers will be confidential and all information collected will be used to make recommendations to Dilico Health Services.
Do you identify as Aboriginal? Aboriginal peoples are defined in the Canadian Constitution Act, 1982, Section 35 (2) as including First Nation, Inuit, and Metis peoples.
Please select one:
2. How long have you been a client/patient of the program?
3. What service(s) did you receive during your visit and how would you rate the service(s)? (Please check service(s) and rating)
Diabetes Care
Diabetes Education
Social Support
Foot Care
Wound Care
4. Overall, how would you rate the quality of care received?
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