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Cancer Care Program CEQ April 14, 2026 - October 14, 2026

Client Experience Questionnaire

Tell us about your experience! Your feedback helps us to improve the way we provide care. This questionnaire was built upon our Patient Values (Dignity, Respect and Trust, Information Sharing, Participation, Accessibility and Responsiveness, and Quality).

This survey is to evaluate the experience you have had within PRAIRIE MOUNTAIN HEALTH Community Cancer Programs. This survey does NOT include experiences you have had with Cancer Care Manitoba based out of Winnipeg.

We do not collect personal information unless you request a follow-up.

If the question does not apply, please leave blank
Do you have a family doctor or Nurse Practitioner
outside of Cancer care?
In the last 6 to 12 months, I have visited the following sites:
(check all that apply)
In the last 6 to 12 months, I have received the following treatments:
(check all that apply)
Dignity, Respect and Trust:
(If the question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a.  I was treated with respect.
b.  My privacy was respected as best it could be.
c.  My cultural needs were considered.
(e.g. individuals’ own beliefs, customs, social standards, traditions or religious beliefs)
d.  Before providing care, staff members introduced themselves to me, where appropriate.
e.  In general, staff were compassionate.
Information Sharing:
(If the question does not apply, leave blank)
Always
Usually
Sometimes
Never
a.  Staff talked to me about what medications I am taking at home. (e.g. prescription, supplements, herbal, etc.)
b.  Staff talked to me about my health care options.
(e.g. procedures/tests)
c.  My health care provider used words I could understand.
d.  I had the necessary information needed to make good decisions about my health.
e.  The staff kept my information confidential and secure.
Participation:
(If the question does not apply, leave blank)
Always
Usually
Sometimes
Never
a.  Staff involved me or my family/support system in making decisions about my care.
b.  I was encouraged to take part in my care as much as I was able.
c.  My choices were respected.
d.  I was comfortable expressing concerns about my care.
Accessibility and Responsiveness:
(If the question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a.  My care was well coordinated.
b.  I was cared for in a timely manner.
c.  I had access to the care I needed.
d.  My concerns were taken seriously.
e.  I am aware of the Prairie Mountain Health (PMH) services and programs available to get the support I need for my health care journey.
Quality:
(If the question does not apply, leave blank)
Always
Usually
Sometimes
Never
a.  I saw the health care provider(s) clean their hands before providing my care.
b.  My identity was confirmed before receiving care.  (e.g. asked my name, checked my wrist band, asked my date of birth)
Quality:
(If the question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
c. My healthcare provider discussed risks or hazards that could cause falls/slips/trips (e.g. side effects from medication, general weakness, etc.)
d.  I felt staff were up to date on the skills needed to provide my care.
e.  Overall, I was satisfied with the quality of care I received.
Cancer Care Program Specific Questions:
(If the question does not apply, leave blank)
Strongly Agree
Agree
Disagree
Strongly Disagree
a. My Systemic therapy medications were clearly explained to me (purpose, dosage, route, administration).
b. The conditions were restful (lighting, noise, temperature, humidity).
c. Phone calls to the community Cancer Care program are returned within 48 working hours.
Cancer Care Program Specific Questions:
(If the question does not apply, leave blank)
Yes
No
d. I have used the electronic Noona application on my computer or mobile device.
Cancer Care Program Specific Questions:
(If the question does not apply, leave blank)
Yes
No
e. Did you receive care at more than one Community Cancer Program within PMH?
f. If Yes, were the transitions between centers satisfactory (moving from one center to another)?
Cancer Care Program Specific Questions:
(If the question does not apply, leave blank)
Yes
No
g. Once you met with your Primary Oncologist (Medical Oncologist or Radiation Oncologist) did you receive treatment at your Community Cancer Center within the timeframe they provided you?
h. I am aware of the following support services:
Yes
No
N/A
a. Dietitian
b. Patient Navigator
c. Social Worker
d. Speech Language Pathologist
e. Occupational Therapist
f. Pharmacist
g. Annual Patient & Family conference
i. I was satisfied with the care/service provided by the:
Yes
No
N/A
a. Physician(s)
b. Nurse(s)
c. Volunteer(s)
d. Radiation Therapist(s)
e. Front Desk Personnel
f. Social Worker(s)
g. Patient Navigator(s)
h. Dietitian
i. Speech Language Pathologist
j. Occupational Therapist
k. Pharmacist
How would you rate the care you received at your Community Cancer Program?
Demographics: (of the patient)
Collected for statistical purposes only to target improvements.
Gender:
Ethnicity:
Age:
Are there any services you would like to see offered at your Community Cancer Program that are not currently available? Please share any additional comments or suggestions.
Forward additional concerns or compliments regarding your care to Patient Relations.
Patient Relations: email patientrelations@pmh-mb.ca or
call 1-800-735-6596


Cancer Care Services Patient Partner Volunteers Needed!! Someone just like you helped to design this survey!
We want to partner with existing Cancer Care Services patients or family members who might be interested in helping us review, design or
provide feedback to our services.


If you would like more information or if you think you might be interested in becoming a Patient Partner, please click on the link below or contact Patient Relations by calling 1-800-735-6596.

https://prairiemountainhealth.ca/forms/patient-partner/
Questions or concerns related to this survey can be sent to ceq@pmh-mb.ca

Thank you for your participation!