Please rate each of the following statements about your most recent consultation (2 weeks or less) with your doctor or health therapist

* 1. How was the doctor at...
Making you feel at ease
(being friendly and warm towards you, treating you with respect; not cold or abrupt)

* 2. How was the doctor at...
Letting you tell "your story"
(giving you time to fully describe your illness in your own words; not interpreting or diverting you)

* 3. How was the doctor at...
Really listening
(paying close attention to what you were saying; not looking at the notes or computer as you were talking)

* 4. How was the doctor at...
Being interested in you as a whole person
(asking/knowing relevant details about your life, your situation; not treating you as "just a number')

* 5. How was the doctor at...
Showing care and compassion
(seeming genuinely concerned, connecting with you on a human level; not being indifferent or "detached")

* 6. How was the doctor at
Fully understanding your concerns
(communicating that he/she had accurately understood your concerns; not overlooking or dismissing anything)

* 7. How was the doctor at
Being positive
(having a positive approach and a positive attitude; being honest but not negative about your problems)

* 8. How was the doctor at...
Explaining things clearly
(fully answering your questions, explaining clearly, giving you adequate information; not being vague)

* 9. How was the doctor at...
Helping you take control
(exploring with you what you can do to improve your health yourself; encouraging rather than : "lecturing" you)

* 10. how was the doctor at...
Making a plan of action with you
(discussing the options, involving you in decisions as much as you want to be involved; not ignoring your views)

* 11. How much empathy did your doctor show (Score out of 10 ie. 0=no empathy, 10=completely empathic)

* 12. How important is it to you for your doctor to be empathic?

* 13. Do you think having a doctor who is emapthic effects the outcome of your treatment?

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