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Canadian Health Care Evaluation Project

Satisfaction Questionnaire

The CANHELP questionnaire has 37 questions and should take about 20 minutes to complete. Once you’ve finished the questionnaire, you’ll get a report with recommendations based on your answers. You can use these recommendations as a starting point for a conversation with your health care team.

Please note that your answers are anonymous and will also be used to collect general information about satisfaction with care to help us better identify opportunities for improvement.

For each of the questions, please tell us first HOW IMPORTANT that statement is in relation to your care. Then tell us HOW SATISIFIED you are right now with that aspect of care over the past month. If you cannot rate your satisfaction with a particular statement (e.g. you have not had home care), please select "N/A".

For example

Question 2. Your doctor takes a personal interest in you and your medical problems

Tell us:

1. How important is this to you?

2. How satisfied are you right now? (do you feel that your doctor takes a personal interest in your and your medical problems?)



Information about the person filling out the questionnaire:  
Are you a patient or a relative/friend of patient:
E-mail address:



 
Information about the patient:  
Sex:
Age:
Where do you live?:  
  In or near a big city
Province/State:
Country:

 
What is the nature of your medical problem?:  
  Heart disease
Emphysema or COPD
Advanced liver disease
Advanced kidney disease
Cancer
Other
General Satisfaction Question(s):  
Satisfaction: 1 = Not at all satisfied, 5 = Completely satisfied
Please indicate whether you are a patient or family member first.




If you would like to clear your session and start the questionnaire over, click here.