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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 tick the number 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:





























ECCH is committed to promoting an environment that values diversity. All staff are responsible for ensuring that all patients and their carers are treated equally and fairly and not discriminated against on the grounds of race, sex, disability, religion, age, sexual orientation or any other unjustifiable reason.