Hospice Palliative Care Survey
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1. 2011 Community Survey

 
Grande Prairie Hospice Palliative Care Society believes in providing services in a Person Centred way. We would like you to share with us your perspective of how your experience was or is currently, with hospice palliative care in our community. If you have not had any experience with hospice palliative care we still need to hear from you. The information gathered will create an agenda for change. GPHPCS is proud to represent our community and need to hear from you to ensure we are working for the community.
Thank you! We value your input and support.
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1. Indicate what category you fall into:
2. If you have experience with hospice palliative care rate your experience.
Very DissatisfiedSomewhat DissatisfiedNeither Satisfied or DissatisfiedSomewhat SatisfiedVery Satisfied
Select one of the following:
3. If you have had experience with hospice palliative care please let us know three things that worked:
4. If you have had experience with hospice palliative care list three things that didn't work:
5. If you have had experience with hospice palliative care list three suggestions you have for the future that will improve the quality of care:
6. If you have no experience with hospice palliative care what three services do you think should be available?
7. I would like to become a volunteer and/or receive newsletters from Grande Prairie Hospice Palliative Care Society.
8. If you would like to become a volunteer or receive newsletters please provide your contact information.
9. Is there any other information you would like to share with us pertaining to hospice palliative care?
10. How did you hear about this survey?
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