Leukaemia Survey

Leukaemia CARE

Patient Survey

This questionnaire is about your care and treatment for a blood cancer. Its purpose is to provide information, which can help the NHS and Leukaemia CARE monitor and improve the quality of health services for future patients with blood cancer.

The data collected will be held and handled securely, and all feedback will be anonymised.

By completing this questionnaire you are giving your consent for the information provided to be used for the above purposes. If you have questions about this or for further information, please call the FREEPHONE helpline given below.

Completing the questionnaire

For each question please tick the box that is closest to your views. Don’t worry if you make a mistake; simply untick the box by clicking on it again and put a tick in the correct box.

If you are helping someone to complete this questionnaire please make sure the information you give is the patient's, not your own.

If you would like to fill out the questionnaire in another language phone the FREEPHONE survey helpline:

0800 783 1775