1. My care started quickly after the referral to the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
2. The referral from my family doctor to the rheumatology patient clinic was dealt with in a timely manner |
□ |
□ |
□ |
□ |
□ |
3. It was difficult to reach the care providers at the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
4. The care providers at the rheumatology patient clinic knew important information about my medical history |
□ |
□ |
□ |
□ |
□ |
5. My family doctor is informed and up‐to‐date about the care I receive at the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
6. My care was well‐coordinated among different care providers at the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
7. I received consistent messages from all of the different care providers at the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
8. The care providers at the rheumatology patient clinic respected my wishes and ideas about my treatment |
□ |
□ |
□ |
□ |
□ |
9. I was as involved as I wanted to be in making decisions about my treatment |
□ |
□ |
□ |
□ |
□ |
10. The care providers at the rheumatology patient clinic asked me about my goals for treatment and what is important to me in managing my condition |
□ |
□ |
□ |
□ |
□ |
11. The care providers at the rheumatology patient clinic responded to all my questions or concerns in a way I could understand |
□ |
□ |
□ |
□ |
□ |
12. The care providers at the rheumatology patient clinic explained the proposed treatment plan to me in a way I could understand |
□ |
□ |
□ |
□ |
□ |
13. Before my treatment, all the risks and/or benefits were explained to me in a way I could understand |
□ |
□ |
□ |
□ |
□ |
14. The care providers at the rheumatology patient clinic explained the reasons for all the tests in a way I could understand |
□ |
□ |
□ |
□ |
□ |
15. The care providers at the rheumatology patient clinic explained my test results to me in a way I could understand |
□ |
□ |
□ |
□ |
□ |
16. The purpose of the medications that were prescribed were explained to me in a way I could understand |
□ |
□ |
□ |
□ |
□ |
17. The information I received about my condition was clear |
□ |
□ |
□ |
□ |
□ |
18. I received information on other options to manage my condition (eg, physiotherapy, acupuncture, chiropractor, nonmedical wellness strategies) |
□ |
□ |
□ |
□ |
□ |
19. The care providers at the rheumatology patient clinic gave me information on how to self‐manage |
□ |
□ |
□ |
□ |
□ |
20. The care providers at the rheumatology patient clinic explained to me what to do if my rheumatoid arthritis gets worse |
□ |
□ |
□ |
□ |
□ |
21. The information I received on peer support groups was useful |
□ |
□ |
□ |
□ |
□ |
22. Overall, I was treated with respect while I was at the rheumatology patient clinic |
□ |
□ |
□ |
□ |
□ |
23. The care providers at the clinic made efforts to understand what having arthritis means to me |
□ |
□ |
□ |
□ |
□ |
Additional comments
|
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ |