Public Health Customer Feedback Card

Region of Peel staff are proud to be working with you. In our continued effort to provide quality customer service, we would like to hear your comments and/or suggestions regarding the service you received.
       
Home Postal Code
How did you contact us?
Phone ROP website
In person
10 Peel Centre Drive 7120 Hurontario
Other (specify)
 
Clinic Location:
Brampton Bolton Fairview
Malton Meadowvale    
Other (specify)
What was the purpose of your contact with the Region of Peel?
 
Breastfeeding Dental Immunization
Prenatal Healthy Sexuality Vaccine Distribution
Other (specify)
 
In what language did you receive this service?
English French
Other (specify)
 
 
Very
Dissatisfied
Very
Satisfied
  1       5
How was your experience accessing the service?
Overall, how satisfied were you with the service you received?
 
To what extent do you agree or disagree with the following statements regarding the service you received?
(Please check the number that best describes your opinion)
 
 
Strongly
Disagree
Strongly
Agree
N/A
  1       5  
Staff made a real effort to make sure I got what I needed
Staff cared about my situation
Staff took the time to understand what I wanted
Procedures were easy to follow
It was clear what to do if I had a problem
 
Did you get what you needed?
Yes No
I got part of what I needed
 
If you wish to comment further on any of our services, please do so below.
 
 
Would you like someone to contact you concerning your comments or any problems you encountered with our service?
Yes
No


Name:

What is your preferred method of contact? (please choose one of the following):

Phone:
E-mail:
 
 

Thank you for your valued feedback!

Notice with Respect to the Collection of Personal Information
(Municipal Freedom of Information and Protection of Privacy Act)

Personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25 and will be used to respond to comments or complaints submitted as well as to ensure the efficiency and effectiveness of programs delivered by the Region. Questions about this collection may be directed to the Manager of the Business Intelligence Centre of Excellence, 10 Peel Centre Drive, Brampton, ON L6T 4B9 (905) 791-7800 ext. 4156.



Revised: Friday September 22 2017

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