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Location Visited: Which of our patient service centres did you go to? BURNABY - 302-3965 Kingsway BURNABY - 324 Gilmore Avenue CAMPBELL RIVER - 277 Evergreen Road COQUITLAM - 536 Clarke Road (Burquitlam Plaza) COQUITLAM - 208 - 3001 Gordon Avenue COURTENAY - 12-1599 Cliffe Avenue DUNCAN - 208-2763 Beverly Street DUNCAN - 102-149 Ingram Street ESQUIMALT - 890B Esquimalt Road GABRIOLA - 1-590 North Road GIBSONS - 821 Highway 101 LADNER - 104-4515 Harvest Drive (Delta Health Sciences Building) LADYSMITH - 541 3rd Avenue (Hillside Medical Clinic) LAKE COWICHAN - 1-78 Cowichan Lake Road MILL BAY - 240-2720 Mill Bay Road NANAIMO - 6010 Brickyard Road NANAIMO - 1151 Lawlor Road NANAIMO - 2-4047 Norwell Drive NANAIMO - 30B-650 South Terminal Road NANAIMO - 87 Wallace Street (Caledonia Medical Clinic) NORTH VANCOUVER - 4313 Gallant Avenue NORTH VANCOUVER - 215-1916 Lonsdale Avenue NORTH VANCOUVER - 209-1200 Lynn Valley Road PARKSVILLE - 103-154 West Memorial Avenue PORT ALBERNI - 4565 Wallace Street QUALICUM BEACH - 2-140 First Avenue RICHMOND - 172-6180 Blundell Road RICHMOND - 170-6451 Buswell Street RICHMOND - 104-3811 Chatham Road RICHMOND - 107-6051 Gilbert Road RICHMOND - 200-5791 No. 3 Road SECHELT - 5531 Inlet Avenue SIDNEY - 101-2475 Bevan Avenue SOOKE - 2050 Townsend Road SURREY - 102-17760 56th Avenue SURREY - 8634 120th Street (Kennedy Professional Building) SURREY - 113-7130 120th Street SURREY - 103-9648 128th Street (Cedar Professional Building) TSAWWASSEN - 114-1077 56th Street (Tsawwassen Medical Building) VANCOUVER - 2-1530 West 7th Avenue (Seymour Medical Clinic) VANCOUVER - 104-888 West 8th Avenue (Laurel Medical Building) VANCOUVER - 4305 West 10th Avenue VANCOUVER - 215-650 West 41st Avenue (Oakridge Mall) VANCOUVER - 112-3540 West 41st Avenue VANCOUVER - 2061 West 42nd Avenue VANCOUVER - 701-750 West Broadway (Fairmont Medical Building) VANCOUVER - 220-943 West Broadway VANCOUVER - 290-2184 West Broadway VANCOUVER - 208-1200 Burrard Street VANCOUVER - 6540 Fraser Street VANCOUVER - 108-3195 Granville Street (Hycroft Medical Building) VANCOUVER - 8677 Granville Street VANCOUVER - 835-777 Hornby Street VANCOUVER - 204-180 Keefer Street (Chinatown Plaza) VANCOUVER - 340-3150 East 54th Avenue VANCOUVER - 408 East Hastings Street VANCOUVER - 5786 Victoria Drive VANCOUVER - 4527 Main Street VICTORIA - 416-645 Fort Street VICTORIA - 6-101 Burnside Road West VICTORIA - 100-1105 Pandora Avenue VICTORIA - 210-547 Michigan Street VICTORIA - 266-2401C Millstream Rd. VICTORIA - 220-172 Wilson Street VICTORIA - 582 Goldstream Avenue VICTORIA - 130-1900 Richmond Avenue VICTORIA - 202-1120 Yates Street VICTORIA - 106-4480 West Saanich Road (Royal Oak Shopping Centre) VICTORIA - 212-1595 McKenzie Avenue VICTORIA - 124-3749 Shelbourne Street VICTORIA - 102-1990 Fort Street VICTORIA - 220-1641 Hillside Avenue WEST VANCOUVER - 109-575 16th Street WEST VANCOUVER - 106-2419 Bellevue Avenue WHITE ROCK - 105-1656 Martin Drive Date of Visit: Time of Visit: How long did you wait? 0 - 20 minutes 21 - 40 minutes more than 40 minutes Was the waiting time acceptable? YES NO Was the facility clean and tidy? YES NO Were you treated in a courteous and professional manner? YES NO Was the procedure performed competently? YES NO Was your overall experience satisfactory? YES NO Would you recommend our service? YES NO Comments: Optional: Name: Address line 1: Address line 2: City: Postal Code: Phone: E-mail address:
Location Visited: Which of our patient service centres did you go to? BURNABY - 302-3965 Kingsway BURNABY - 324 Gilmore Avenue CAMPBELL RIVER - 277 Evergreen Road COQUITLAM - 536 Clarke Road (Burquitlam Plaza) COQUITLAM - 208 - 3001 Gordon Avenue COURTENAY - 12-1599 Cliffe Avenue DUNCAN - 208-2763 Beverly Street DUNCAN - 102-149 Ingram Street ESQUIMALT - 890B Esquimalt Road GABRIOLA - 1-590 North Road GIBSONS - 821 Highway 101 LADNER - 104-4515 Harvest Drive (Delta Health Sciences Building) LADYSMITH - 541 3rd Avenue (Hillside Medical Clinic) LAKE COWICHAN - 1-78 Cowichan Lake Road MILL BAY - 240-2720 Mill Bay Road NANAIMO - 6010 Brickyard Road NANAIMO - 1151 Lawlor Road NANAIMO - 2-4047 Norwell Drive NANAIMO - 30B-650 South Terminal Road NANAIMO - 87 Wallace Street (Caledonia Medical Clinic) NORTH VANCOUVER - 4313 Gallant Avenue NORTH VANCOUVER - 215-1916 Lonsdale Avenue NORTH VANCOUVER - 209-1200 Lynn Valley Road PARKSVILLE - 103-154 West Memorial Avenue PORT ALBERNI - 4565 Wallace Street QUALICUM BEACH - 2-140 First Avenue RICHMOND - 172-6180 Blundell Road RICHMOND - 170-6451 Buswell Street RICHMOND - 104-3811 Chatham Road RICHMOND - 107-6051 Gilbert Road RICHMOND - 200-5791 No. 3 Road SECHELT - 5531 Inlet Avenue SIDNEY - 101-2475 Bevan Avenue SOOKE - 2050 Townsend Road SURREY - 102-17760 56th Avenue SURREY - 8634 120th Street (Kennedy Professional Building) SURREY - 113-7130 120th Street SURREY - 103-9648 128th Street (Cedar Professional Building) TSAWWASSEN - 114-1077 56th Street (Tsawwassen Medical Building) VANCOUVER - 2-1530 West 7th Avenue (Seymour Medical Clinic) VANCOUVER - 104-888 West 8th Avenue (Laurel Medical Building) VANCOUVER - 4305 West 10th Avenue VANCOUVER - 215-650 West 41st Avenue (Oakridge Mall) VANCOUVER - 112-3540 West 41st Avenue VANCOUVER - 2061 West 42nd Avenue VANCOUVER - 701-750 West Broadway (Fairmont Medical Building) VANCOUVER - 220-943 West Broadway VANCOUVER - 290-2184 West Broadway VANCOUVER - 208-1200 Burrard Street VANCOUVER - 6540 Fraser Street VANCOUVER - 108-3195 Granville Street (Hycroft Medical Building) VANCOUVER - 8677 Granville Street VANCOUVER - 835-777 Hornby Street VANCOUVER - 204-180 Keefer Street (Chinatown Plaza) VANCOUVER - 340-3150 East 54th Avenue VANCOUVER - 408 East Hastings Street VANCOUVER - 5786 Victoria Drive VANCOUVER - 4527 Main Street VICTORIA - 416-645 Fort Street VICTORIA - 6-101 Burnside Road West VICTORIA - 100-1105 Pandora Avenue VICTORIA - 210-547 Michigan Street VICTORIA - 266-2401C Millstream Rd. VICTORIA - 220-172 Wilson Street VICTORIA - 582 Goldstream Avenue VICTORIA - 130-1900 Richmond Avenue VICTORIA - 202-1120 Yates Street VICTORIA - 106-4480 West Saanich Road (Royal Oak Shopping Centre) VICTORIA - 212-1595 McKenzie Avenue VICTORIA - 124-3749 Shelbourne Street VICTORIA - 102-1990 Fort Street VICTORIA - 220-1641 Hillside Avenue WEST VANCOUVER - 109-575 16th Street WEST VANCOUVER - 106-2419 Bellevue Avenue WHITE ROCK - 105-1656 Martin Drive
Date of Visit:
Time of Visit:
How long did you wait? 0 - 20 minutes 21 - 40 minutes more than 40 minutes
Comments:
Optional:
Name:
Address line 1:
Address line 2:
City:
Postal Code:
Phone:
E-mail address: