Patient Exit Survey


This is the Patient Satisfaction Survey developed and distributed through the AYAH CoIIN. 

We want to know if we’re doing a good job providing health care to patients your age. Please complete this two-minute survey to let us know.  Your comments will be used to make improvements to our clinic and health care services. This survey is completely CONFIDENTIAL. Your individual answers will not be shared with anyone.

There are 34 questions in this survey.

A note on privacy
This survey is anonymous.
The record of your survey responses does not contain any identifying information about you, unless a specific survey question explicitly asked for it. If you used an identifying token to access this survey, please rest assured that this token will not be stored together with your responses. It is managed in a separate database and will only be updated to indicate whether you did (or did not) complete this survey. There is no way of matching identification tokens with survey responses.