Important:

Access our online Klinik triage system here

Shared Clinical Decision Making Survey

Please fill out our anonymous questionnaire and let us know how included you felt in the decision making of your health care.  

 

This questionnaire is completely anonymous so you do not need to worry about your name being shared. 

Write your answer in the box below
Write your answer in the box below.
1. My doctor made clear that a decision needs to be made.
Please select one of the following six options
2. My doctor wanted to know exactly how I want to be involved in making the decision.
Please select one of the following six options
3. My doctor told me that there are different options for treating my medical condition.
Please select one of the following six options
4. My doctor precisely explained the advantages and disadvantages of the treatment options.
Please select one of the following six options
5. My doctor helped me to understand all the information.
Please select one of the following six options
6. My doctor asked what treatment option I prefer.
Please select one of the following six options
7. My doctor and I thoroughly weighed the different treatment options.
Please select one of the following six options
8. My doctor and I selected a treatment option together.
Please select one of the following six options
9. My doctor and I reached an agreement on how to proceed.
Please select one of the following six options