Survey | Let's Talk Horizon

1.

Did you find it helpful to complete screen that asked about your symptoms?

2.

Did your health care provider discuss your symptoms each time you completed a screen?

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3.

If you discussed your symptoms with your care provider, how useful was the conversation?

4.

How satisfied are you with the emotional support you received from your health care provider?

5.

How satisfied are you with the practical information you received from your health care provider?

6.

Did your health care provider help you with the concerns bothering you the most on the screening for distress questionnaire? (check all that apply)

Practical Issues (e.g., finances, getting to and from appointments

Social/Family Issues (e.g., worry about friends and family)

Emotional Issues (e.g., fears and worries, sadness, intimacy/sexuality)

Spiritual Issues (e.g., meaning/purpose of life, faith)

Informational Issues (e.g., understanding my illness, talking with the cancer care team)

Physical Issues (e.g., pain, fatigue)

Other Issues (e.g., not mentioned above)

7.

If you felt any of issues were not addressed appropriately, please explain.

8.

Were you referred to another health care provider as a result of your symptoms?

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9.

How satisfied were you with the tool used to entre your data?

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