Skip to main content

Bereavement Questionnaire


Section A: The patient – Prior to death.

These questions help us to understand more about the care your relative / friend received prior to their death. (I.e. in their last days). Please select the response which best represents your answer to the question and make any comments at the end of the questionnaire.

A: In your opinion the patient was:

Cookie Notice

Find out more about how this website uses cookies to enhance your browsing experience.