Patient Questionnaire for Cancer Care Reviews

Please only complete this form if you have been requested by the practice.

Over the past year you’ve been invited for a Cancer Care Review, with our Cancer Nurse, Jacqui Graves. We’d really like to know what you thought about your review.

This questionnaire should take no more than 15 minutes to complete, and we really appreciate your feedback so that we can further improve services.

Patient Questionnaire for Cancer Care Reviews

Patient Questionnaire for Cancer Care Reviews

Was the purpose and goals of the Cancer Care Review (CCR) clear to you before you attended the appointment? *
On a scale of 0 being not clear and 10 being very clear
If you completed the Cancer Care Concerns Checklist in advance of your CCR, how helpful was it in identifying your concerns? *
On a scale of 0 being not helpful and 10 being very helpful

At your review, how good was the nurse at each of the following:

Giving you enough time *
On a scale of 0 being not good and 10 being very good
Listening to you *
On a scale of 0 being not good and 10 being very good
Explaining tests and treatment *
On a scale of 0 being not good and 10 being very good
Involving you in decisions about your care *
On a scale of 0 being not good and 10 being very good
Treating you with care and concern *
On a scale of 0 being not good and 10 being very good
Did you have confidence and trust in the nurse you saw/spoke to? *
On a scale of 0 being no confidence/trust and 10 being full confidence/trust
You should have received a copy of your Cancer Action Plan (CAP) via a text link. The CAP will be a summary of the review, to enable you to move forward and self-manage. How confident are you to take forward the CAP? *
On a scale of 0 being not confident and 10 being fully confident