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Patient Appointment Request Feedback

Thank you for using the Patient Appointment Request Service (PARS). Please use this form to send us any suggestions or comments about this electronic appointment request service offered in the Chatham-Kent Community Portal. Your comments and suggestions will help us improve our service.

* Indicates a mandatory field
Name: * 
Telephone: *  
Email: * 
Address:
City: Prov:
Postal Code/ZIP:
Presentation:- Your assessment of our screen design, ease of use and interactive forms:
Excellent Good Fair Needs Work
Convenience:- Do you think our web appointment request service is convenient?
Excellent Good Fair Needs Work
Other comments?
Posting created by: Information Technology group.
Last updated: Thursday, May 04, 2006
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