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Provider Feedback

At Culturally Committed, we recognize that it can be difficult for individuals to offer feedback to their provider -- even if that information could potentially improve the appointment experience.

This is why we offer an anonymous feedback pathway: Culturally Committed Providers WANT to know how to create safer spaces for Indigenous clients, and are committed to integrating feedback into their practice. 

Please note: this form is NOT intended to collect your personal health information. Please provide feedback solely on your interactions with your provider, and their ability to create a feeling of safety and security during your interactions.

Rate Your ExperiencePoorFairGoodVery goodExcellentRate Your Experience

Rate your overall experience: 5 represents a high level of cultural safety experienced at your appointment. 

At Culturally Committed, we recognize that individuals may be hesitant to provide feedback due to fear of repercussion, fear that feedback won’t be taken seriously, or because they are afraid that what they say may be easily traced back to them (even when submitted anonymously). For these reasons, we offer three options for providing feedback:

Option 1: Feedback will be anonymously forwarded directly to your provider.

Option 2: Feedback will be anonymously shared with all Culturally Committed providers as a group. This eliminates the fear that feedback can be traced back to an individual, and also creates an opportunity for all Culturally Committed providers to learn from your feedback and experiences.

Option 3: Feedback can be anonymously shared with Culturally Committed, but will not be shared with any Culturally Committed providers. With this option, Culturally Committed will use your feedback to help shape future topics for learning and discussion.

If you have experienced a triggering event, it is important to seek help. Indigenous peoples who require emotional support can contact the 24-hour KUU-US Crisis Line at

1-800-588-8717, or the Indian Residential School Survivors Society at 1-800-721-0066.

How would you like this information to be used?

Disclaimer: Culturally Committed does not have the ability to escalate issues or complaints. To submit a formal complaint about a health provider in British Columbia, please contact the relevant regulatory college.

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