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Complex medical needs survey

If you are looking to complete the bereavement survey, please click here.

Your perspectives and insights about the experience with your child are important. These will guide us towards meaningful enhancements to the services we provide to children and their families. Thank you for taking the time to fill out this survey.

1.  

What is your child's current age?

* required

Maximum 255 characters

0/255

3.  

What was your child’s age at the time of diagnosis?

* required
4.  

When were the goals of care for your child first discussed?

Check all that apply.

* required
5.  

Is your child’s care plan reviewed and assessed with each visit?

* required
6.  

Do you feel your child’s pain is well managed?

* required
7.  

Do you have access to counselling (spiritual care, social work, psychology)?

* required
8.  

Are the cultural needs of your family being met?

* required
9.  

Are there financial barriers for accessing the support your child needs (ex. Travel, medical supplies, etc)

* required

Maximum 20,000 characters

0/20,000

11.  

To continually improve our services to our patients and their families, would you be willing to be contacted by a Horizon staff member to discuss your experience?

* required