Submit a Review Submit a Review Step 1 of 3 - Personal Information 0% HiddenFeedback DetailsPremier Health & Wellness Centre Patient Feedback Form Thank you for choosing Premier Health & Wellness Centre for your healthcare needs. We strive to continuously improve the quality of our services and greatly value your input. Please take a moment to complete this short survey about your recent experience with us.Date of visit(Required) MM slash DD slash YYYY Personal InformationYour Name(Required) First Last Location of Visit (Hamilton/St. Georges):(Required)Choose locationHamiltonSt. GeorgesEmail Address(Required) Primary Contact NumberPreferred Method of Contact (if needed)EmailPhone Service Received or Program(Required)Choose Service or ProductWeight Loss ProgramDiabetes ReversalPrimary Care & Internal MedicineDiagnosticsNutritional TherapySexual WellnessYour Feedback(Required) Service or Program EvaluationHow would you rate the ease of scheduling your appointment?Submit RatingVery EasyEasyNeutralDifficultVery DifficultStaff EvaluationHow would you rate the friendliness and professionalism of our staff?Submit RatingVery SatisfactorySatisfactoryNeutralVeryUnsatisfactoryHealthcare Professional EvaluationHow would you rate the communication skills of your healthcare professional?Submit RatingVery GoodGoodNeutralPoorVery PoorHow would you rate the quality of care provided by your healthcare professional?Submit RatingVery GoodGoodNeutralPoorVery PoorFacility EvaluationHow would you rate the cleanliness and comfort of our facility?Submit RatingVery GoodGoodNeutralPoorVery PoorOverall ExperienceOverall, how would you rate your experience at Premier Health & Wellness Centre?Submit RatingVery SatisfactorySatisfactoryNeutralVeryUnsatisfactoryOpen FeedbackWhat did you like most about your experience with us?What improvements would you suggest for Premier Health & Wellness Centre?RecommendationWould you recommend Premier Health & Wellness Centre to a friend or family member?Submit RatingDefinitely willProbably willMight or might notProbably notDefinitely notPermission to Use FeedbackDo we have your permission to use your feedback for promotional and improvement purposes?(Required)ChooseYesNo
