Metro North Cancer Care Services Patient Experience Survey

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Closes 11 May 2021

Introduction

1. Please choose the month and year you are completing the survey
2. What is your postcode?
3. Gender
4. Age
5. Are you Aboriginal or Torres Strait Islander?
6. Are you of Australian South Sea Islander origin?
7. Do you speak a language other than English at home?
8. Today my feedback relates to Cancer Services in (Please select)
9. Today I was an inpatient in
10. Today I had a doctors appointment in (please select appropriate facility clinic)
11. Today I had treatment/assessment/screening in
12. Do you attend Cancer Services at more than one facility?
13. If yes, which services and facilities do you attend?
14. Has a staff member spoken to you about your Healthcare rights or have you received a brochure about your Healthcare rights prior to or when you attended the service?
15. Do you understand you have the right to Access services in a timely manner, Safety, Respect, Communication, Participation in your care, Privacy and Comment?
16. Do you have a carer/support person with you today?