1. My views and concerns were listened to:
2. My individual needs were met (if answer always/mostly, skip to Q4)
3. When a need could not be met, staff explained why
5. I was involved as much as I wanted in making decisions about my treatment and care
6. I was kept informed as much as I wanted about my treatment and care
7. As far as I could tell, the staff involved in my care communicated with each other about my treatment
8. I received pain relief that met my needs
9. When I was in the hospital, I felt confident in the safety of my treatment and care
10. I experienced unexpected harm or distress as a result of my treatment or care (if answer is no, skip to Q12
11. My harm or distress was discussed with me by staff
12. Overall, the quality of the treatment and care I received was:
