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Patient Decision-Making Survey: Share Your Experience

This survey aims to understand your involvement in healthcare decisions after your appointment. We value your feedback on whether you received answers to three critical questions: What are my options? What are the potential benefits and risks of those options? How likely are these outcomes? The survey takes approximately three minutes to complete and is entirely voluntary and anonymous. Your insights will help us improve our patient care. Please circle your responses and return the survey in the ‘SHARED DECISION MAKING’ box at reception. Thank you for your participation!

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Patient Decision-Making Survey: Share Your Experience

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  1. Survey Template: How it works: The template uses Powerpoint, Arial fonts and the text and content can be adapted to suit your organisations needs

  2. Ask 3 Questions Sometimes there will be choices to make about your healthcare. If you are asked to make a choice, make sure you get the answers to 3 questions. What are my options? What are the possible benefits and risks of those options How likely are the benefits and risks of each option to occur? We want to know what’s important to you? Add your logo

  3. Did you get the answers to the 3 questions? We want to find out how much you were involved in decisions about your care and treatment so We can do a better job for our patients. This survey will take around 3 minutes to complete and is Entirely voluntary. Your answers will be completely anonymous. If you need help completing the Survey, please ask a receptionist. Please complete this survey after your appointment Please circle your response Thank you for completing this survey Please post back in the ‘SHARED DECISION MAKING’ box at reception

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