Service Referral Initiative feedback questionnaire

The Government of Canada would like to learn more about the client experience. Participation is voluntary. Your feedback will be used to help the Government of Canada improve the quality of service. The survey will take approximately 3 minutes to complete. Thank you for participating.

Privacy statement

The information you provide is collected under the authority of the Department of Employment and Social Development Act for the purpose of measuring and continually improving the performance of the Service Referral Initiative. Your participation is voluntary.

Please do not include any personal information about yourself or anyone else when responding to this survey, such as a name, address, telephone number, email address, Social Insurance Number, departmentally-assigned case or file number or any other information by which you or anyone else can be identified.

Any personal information collected will be administered in accordance with the Department of Employment and Social Development Act, the Privacy Act and other applicable privacy laws governing the protection of personal information under the control of the Department of Employment and Social Development. Survey responses will not be attributed to individuals.

The information you provide may be used and/or disclosed for policy analysis, research and/or evaluation purposes. However, these additional uses and/or disclosures of your personal information will never result in an administrative decision being made about you.

If you wish to obtain information related to this survey, you may submit an access to information and privacy (ATIP) request to the Department of Employment and Social Development pursuant to the Access to Information Act.

You have the right to file a complaint with the Privacy Commissioner of Canada regarding the institution’s handling of your personal information.

When making a request, please refer to the name of this survey: Service Referral Initiative.

1. In general, what works well or does not work well for you, the client, and/or your organization while accessing government services?

In your responses, you agree to not include any personal information about yourself or anyone else; this includes name, date of birth, Social Insurance Number, mail or email addresses, or any other information by which you or your clients could be identified by your comments or views. Questions related to your individual case will not receive a reply. Thank you.

2. Thinking about a specific experience that you feel is important to share, what went well and what did not work well related to the client experience?

3. Which program(s) does this feedback apply to? Please select all that apply:

Employment Insurance

Social Insurance Number

Canada Pension Plan

Canada Pension Plan - Disability

Old Age Security or Guaranteed Income Supplement

Canadian Dental Care Plan

Other (please specify):

4. Is this feedback specific to particular client groups? If so, please specify:

Examples of client groups would be: Indigenous people, LGBTQ2+ community, low-income / homeless, newcomers / immigrants, people with disabilities, racialized Canadians, Temporary Foreign Worker, vulnerable families, vulnerable seniors, vulnerable youth, other.

5. Please identify the province or territory relevant to this feedback:

6. Please identify the postal code of your local organization:

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Date modified:: 2024-07-17

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Service Referral Initiative feedback questionnaire

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