HCC & CPSS Survey

Home and Community Care & Community and Personal Support Satisfaction Survey

HCC & CPSS 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.
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)
Care Management
Visiting Nursing
Occupational Therapy
Social Work
Speech / Language
Adult Life Enrichment
Personal Care
Wound Care
Foot Care provided by:
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