Atikokan General Hospital / Services

Customer Feedback Form

Atikokan General Hospital is committed to providing the best service possible to our clients. We welcome feedback from the public on ways to improve our services. Feedback from persons with disabilities may be received by telephone, in person, writing, electronic format, Email or other methods. You may phone us at 807-597-4215 for additional information or assistance.

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Date of Service:
	Invalid format.A value is required.
Department of Service:
	Please select a department.
Did we meet your needs?
	YES SOMEWHAT NO Please make a selection.
If NO please explain:

Were you able to access services?
	YES SOMEWHAT NO Please make a selection.
If NO please explain:

Was service provided in a way that respected your dignity and independence?
	YES SOMEWHAT NO Please make a selection.
If NO please explain:


CONTACT INFORMATION (OPTIONAL)
Name:
Address:
Phone (day):	Invalid format - expected (807) 597-4215.
Fax:	Invalid format - expected (807) 597-4215.
Email:	Invalid format.

AGH Services

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