Cancer Clinical Trials

Satisfaction Survey

Age
Under 19    20 - 29    30 - 39    40 - 49    50 - 59    60 or older   

Gender
Male    Female   

Ethnicity
White    Black    American Indian or Alaskan Native    Asian or Pacific Islander    Hispanic    Other    No Response   

Who filled out the survey?
Patient    Care giver   

Consent Process

How would you rate:

Your understanding of the purpose of the study as it was explained to you including the potential risks involved?
Excellent    Very Good    Good    Fair    Poor   

Do you have any comments about the consent process?


Scheduling

How would you rate:

The courtesy and friendliness of the staff that you talked with about scheduling?
Excellent    Very Good    Good    Fair    Poor   

Do you have any comments about scheduling?


Arrival and Checkout Process

How would you rate:

The length of time you waited to be seen for your appointment?
Excellent    Very Good    Good    Fair    Poor   

Do you have any comments about the arrival and checkout process?


Staff

How would you rate:

The doctor or research nurse on explaining your participation in a clinical research trial?
Excellent    Very Good    Good    Fair    Poor   

The level of confidence and trust you had in the research nurse?
Excellent    Very Good    Good    Fair    Poor   

The level of confidence and trust you had in the doctor?
Excellent    Very Good    Good    Fair    Poor   

Do you have any comments about the staff?


Overall Experience:

The likelihood that you would recommend participating in a Clinical Research Center study to others?
Excellent    Very Good    Good    Fair    Poor   

Would you please provide the name of any staff member that you would like to mention for any reason and what that individual did for you?


What suggestions do you have for the medical provider and staff to improve their services to you?