Your feedback is important to us Name First Name Last Name Select if you would you like this feedback to remain anonymous. Email If you require a response, please leave either your email or phone number Contact Number If you require a response, please leave either your email or phone number Does your feedback relate to a particular clinician? If yes: Brie Simons Natalie Grainger Navreen Madan Would you recommend Network Speech Pathology to others? Yes No FEEDBACK RATING SCALES Please rate the following statements: My appointments were scheduled within a reasonable time frame. Strongly Disagree Disagree Neutral Agree Strongly Agree The clinician was courteous, respectful and professional. Strongly Disagree Disagree Neutral Agree Strongly Agree The clinician was prepared, organised and instilled confidence. Strongly Disagree Disagree Neutral Agree Strongly Agree The clinician helped inform me about my condition. Strongly Disagree Disagree Neutral Agree Strongly Agree My treatment program resulted in positive outcomes. Strongly Disagree Disagree Neutral Agree Strongly Agree The telehealth program was easy to use and access. Strongly Disagree Disagree Neutral Agree Strongly Agree Do you have any suggestions to improve the service? Thank you for taking the time to provide us with feedback.If you would like to provide further feedback, you can contact the Director Brie Simons on 0493 462 430 or info@networkspeechpathology.com.
