PEFHT Lung Health Program 2026

The Prince Edward Family Health Team would like to know more about your experience as a patient of our health care team. We will be using your feedback to improve the quality of our programs and services and make changes that we hope will exceed your expectations.

Thank-you for your time.

Question Title

* 1. How confident do you feel in following your Action Plan?

Extremely confident

Very confident

Somewhat confident

Not so confident

Not at all confident

No Action Plan Assigned Yet

Question Title

* 2. If you have COPD who would you call if you had questions about your symptoms or you progressed to the Orange zone of your Action Plan?

Question Title

* 3. If you have Asthma who would you call if you had questions about your symptoms or you progressed to the Yellow zone of your Action Plan?

Question Title

* 4. Who would you call if your symptoms progressed to the Red zone of your Action Plan?

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* 5. Which health teaching styles best suit your needs?
(pick all that apply)

Hands on.

Verbal instructions.

Paper instructions you can review at home on your own time.

Combination of verbal and paper.

Other (please specify)

Question Title

* 6. What are the top areas that you would like to receive more information on?
(pick all that apply)

How COPD changes over time?

How to better manage COPD symptoms?

Smoking Cessation counseling.

How to exercise safely and confidently.

End of life / Advanced care planning.

Other (please specify)

PEFHT Lung Health Program 2026

Question Title

* 1. How confident do you feel in following your Action Plan?

Question Title

* 2. If you have COPD who would you call if you had questions about your symptoms or you progressed to the Orange zone of your Action Plan?

Question Title

* 3. If you have Asthma who would you call if you had questions about your symptoms or you progressed to the Yellow zone of your Action Plan?

Question Title

* 4. Who would you call if your symptoms progressed to the Red zone of your Action Plan?

Question Title

* 5. Which health teaching styles best suit your needs?(pick all that apply)

Question Title

* 6. What are the top areas that you would like to receive more information on?(pick all that apply)

* 5. Which health teaching styles best suit your needs?
(pick all that apply)

* 6. What are the top areas that you would like to receive more information on?
(pick all that apply)