Hospice Peterborough evaluates all of our programs and services. This survey is part of our efforts to adapt and change programs to meet the needs of our community. Your participation in this survey is completely voluntary, and your responses will not impact any current or future services that you are receiving from Hospice Peterborough.

This survey is for clients, family members, and/or loved ones that are connected to any of the Hospice Peterborough programs and services.

This survey will take up to 5 minutes to complete. All information collected in this survey will remain anonymous and confidential. If you include any information that may identify yourself or your person, we will modify the response for reporting to ensure you cannot be identified.

If you have any questions, please contact: Natalie Warner, Manager of Community Programs, 705-742-4042 or email nwarner@hospicepeterborough.org.

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* 1. What is your connection to Hospice Peterborough? (select all that apply)

I am a:

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* 2. Have you or your loved one received care from Hospice Peterborough’s Community Palliative Care Program? (this includes the visiting Nurse Navigator and/or Supportive care in the home)

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