Bereavement questionnaire Question Title * 1. Please tell us the name of the ward that your friend or relative died on. Question Title * 2. In your opinion, was hospital the right place for your friend / relative to receive care at the end of their life? Yes, definitely Yes, to some extent No, not really No, not at all N/A Question Title * 3. Please tell us why Question Title * 4. Do you feel your friend / relative's care needs were met during the last few days of their life? Yes, definitely Yes, to some extent No, not really No, not at all N/A Question Title * 5. Please tell us more about this Question Title * 6. Were you involved in discussions with staff about your friend / relative's care during the last few days of their life? Yes, definitely Yes, to some extent No, not really No, not at all N/A Question Title * 7. Please tell us more about this Question Title * 8. Did you feel supported by staff at the RUH in the days before your friend / relative died? Yes, definitely Yes, to some extent No, not really No, not at all N/A Question Title * 9. Please tell us more about this Question Title * 10. Did you feel supported by the staff in the Bereavement and Medical Examiner office in the days after your friend / relative died? Yes, definitely Yes, to some extent No, not really No, not at all N/A Question Title * 11. Please tell us more about this Question Title * 12. If you think that there was anything that was done well at the RUH, or that made a difference to you or your friend or relative, please tell us more here. Question Title * 13. If you think the RUH could have done more to support you and your relative / friend, please tell us more here. If you have any concerns about the care and support provided, please contact our Patient Support and Complaints Team on 01225 825656 / ruh-tr.psct@nhs.net Done