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Central Zone Palliative Care Services - Patient & Family Experience Survey

For the purposes of this survey, the palliative care team member(s) may include nurses, physicians, social workers, music therapists, bereavement coordinators, and volunteers that work specifically within the palliative care service.

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Confidentiality and Instructions


For each item, select the answer that is closest to your experience. Before you answer, please remember:

  • Your name will not appear anywhere on the survey.
  • Your answers are completely anonymous and confidential.
  • You can choose whether to fill this survey out or not. You can skip any question you don’t want to answer. You can stop answering at any point. 
  • Regardless of how many questions you answer, ensure you press "SUBMIT" at the end of the survey to have your answers saved.
  • There are no right or wrong answers.


We understand that answering questions may be emotionally difficult so we again thank you for taking the time to help us improve the care we provide.

Sincerely,

Central Zone Palliative Care Services