All questions are mandatory
Choose a facility Atherton Hospital Babinda Hospital Cairns Hospital Gordonvale Hospital Herberton Hospital Innisfail Hospital Mareeba Hospital Mossman MPHS Tully Hospital
Overall, how would you rate the care you received while in hospital?
1 - Very poor 2 - Poor 3 - Neither good nor poor 4 - Good 5 - Very good
Did you feel you were treated with respect and dignity while you were in hospital?
Yes,always Yes, sometimes No
Did the health professionals explain things in a way you could understand?
Yes, always Yes, sometimes No
Were you involved, as much as you wanted to be, in decisions about your care and treatment?
Yes, definitely Yes, to some extent No, I was not well enough to be involved
If your family or someone else close to you wanted to talk to a doctor, did they get the opportunity to do so?
Yes,definitely Yes, to some extent No, they did not get the opportunity Not applicable to my situation
Q5a (If no, continue to Q6)
Did you have worries or fears about your condition or treatment while in hospital?
Did a healthcare professional discuss your worries or fears?
Yes, completely Yes, to some extent No
How much information about your condition or treatment was given to your family, carer or someone close to you?
Not enough Right amount Too much It was not necessary to provide information to any family or friends Don't know / can't say
Q7a (If no, please continue to Q8)
Were you ever in any pain while in hospital?
Do you think the hospital staff did everything they could to help manage your pain?
Yes, definitely Yes, to some extent No
If you needed assistance, were you able to get a member of staff to help you within a reasonable time frame?
All of the time Most of the time Some of the time Rarely Never You did not need assistance
How clean were the toilets and bathrooms that you used while in hospital?
Very clean Fairly clean Not very clean Not clean at all
Thinking about when you left hospital, were you given enough information about how to manage your care at home?
Yes, completely Yes, to some extent No, I was not given enough I did not need this type of information
Thinking about when you left hospital, were adequate arrangements made by the hospital for any services you needed?
Yes, completely Yes, to some extent No, arrangements were not adequate I did not need any services
How would you rate how well the doctors and nurses worked together?
1 - Very good 2 - Good 3 - Neither good nor poor 4 - Poor 5 - Very poor I don't know
What year were you born?
Which language do you mainly speak at home?
English A language other than English, please specify:
In general, would you say your health is?
Excellent Very good Good Fair Poor
Are you of Aboriginal origin, Torres Strait Islander origin or both?
Yes, Aboriginal Yes, Torres Strait Islander Yes, both Aboriginal and Torres Strait Islander No