1. Was the doctor polite and considerate? *

2. Did the doctor listen to what you had to say? *

3. Did the doctor give you enough opportunity to ask questions? *

4. Did the doctor answer all your questions? *

5. Did the doctor explain things in a way you could understand? *

6. Are you involved as much as you want to be in the decisions about your care and treatment? *

7. Did you have confidence in the doctor? *

8. Did the doctor respect your views? *

9a. If the doctor examined you, did he or she ask your permission? *

9b. If the doctor examined you, did he or she respect your privacy and dignity? *

10. By the end of the consultation did you feel better able to understand and/or manage your condition and your care? *

11. Overall, how satisfied were you with the doctor that you saw? *