Patient Satisfaction Survey Please help us to serve you better by completing this survey. It should take around 5 minutes to complete. Your Name (optional) Your Email (optional) Program Evaluation On a scale of 1 - 4 please rate the following Wait time before starting cardiac rehabilitation PoorFairGoodExcellent Duration of the program (6 months) PoorFairGoodExcellent Program facilities (accessible, clean, functional) PoorFairGoodExcellentN/A Professionalism and knowledge displayed by program staff PoorFairGoodExcellent Access to additional resources (dietitian, certified tobacco educator, community resources – Diabetes Education, etc.) PoorFairGoodExcellent Helpfulness of program volunteers PoorFairGoodExcellentN/A Content of weekly in-class education sessions PoorFairGoodExcellent Content of educational handouts PoorFairGoodExcellent Overall program satisfaction PoorFairGoodExcellent Personal Achievements On a scale of 1 - 4 please rate the following Improvement in exercise endurance N/AUnsatisfiedSomewhat SatisfiedSatisfied Improvement in ability to perform activities of daily living N/AUnsatisfiedSomewhat SatisfiedSatisfied Improvement in self-confidence N/AUnsatisfiedSomewhat SatisfiedSatisfied Improvement in knowledge of how to modify risk factors for cardiovascular disease N/AUnsatisfiedSomewhat SatisfiedSatisfied Improvement in satisfaction of social activities N/AUnsatisfiedSomewhat SatisfiedSatisfied Improvement in satisfaction of recreational activities N/AUnsatisfiedSomewhat SatisfiedSatisfied Change in Cardiovascular Disease Risk Factors On a scale of 1 - 4 please rate the following Waist measurement N/AUnsatisfiedSomewhat SatisfiedSatisfied Cholesterol N/AUnsatisfiedSomewhat SatisfiedSatisfied Diabetes N/AUnsatisfiedSomewhat SatisfiedSatisfied Blood pressure N/AUnsatisfiedSomewhat SatisfiedSatisfied Eating habits and dietary intake N/AUnsatisfiedSomewhat SatisfiedSatisfied Smoking N/AUnsatisfiedSomewhat SatisfiedSatisfied Stress and coping behaviours N/AUnsatisfiedSomewhat SatisfiedSatisfied Active Lifestyle N/AUnsatisfiedSomewhat SatisfiedSatisfied Please make any additional comments and/or suggestions below:
