Consumers Can Ask Brief Survey 1. Question Title * 1. BEFORE reading this resource, how would you rate your KNOWLEDGE of questions to ask staff of health services about treatment and discharge planning? Extremely poor Below average Average Above average Excellent Additional comments Question Title * 2. AFTER reading this resource, how would you rate your KNOWLEDGE of questions to ask staff of health services about treatment and discharge planning Extremely poor Below average Average Above average Excellent Additional comments Question Title * 3. BEFORE reading this resource, how would you rate your CONFIDENCE in asking staff of health services about treatment and discharge planning? Extremely poor Below average Average Above average Excellent Additional comments Question Title * 4. AFTER reading this resource, how would you rate your CONFIDENCE in asking staff of health services about treatment and discharge planning Extremely poor Below average Average Above average Excellent Additional comments Question Title * 5. People often say they are asked if they have any questions, but they don't know what to ask. Yes No Has that been your experience Has that been your experience Yes Has that been your experience No Has this resource helped? Has this resource helped? Yes Has this resource helped? No Does this resource make you feel more confident? Does this resource make you feel more confident? Yes Does this resource make you feel more confident? No Question Title * 6. Would you use the resouce again? Yes No Additional Comments Question Title * 7. Would you recommend the Consumers Can Ask resource to others? Yes No Question Title * 8. Do you think the Consumers Can Ask resource will assist you to assist you? Yes No Additional Comments Question Title * 9. Do you have any other comments you wish to make? 50% of survey complete. Next