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YOU ARE STRONGLY URGED TO PLEASE RESPOND TO THE SURVEY
There are 5 ways to submit your response. From the web site, or by regular mail, email, fax, or phone.

Web site (preferred method)
www.healthcareneglect.com		 Email
edrex1@sympatico.ca		 Regular Mail
Ed Mendoza
1832 Simard Dr.
Orleans, Ontario
K1C 2P8 		  Fax
(613) 837-0369
   Phone
(613) 837-7199
IMPORTANT:
1. To be counted as a recipient of the survey you must give your postal code. Without a postal code you won't be considered a survey recipient but still can respond. Please do so. Your input is extremely necessary.
2. Your comments are highly important. Please give your own views, relate personal experiences and offer any suggestions for improvement. Also, please express your opinion about statement number 5.
Personal Information:
 The information you give will be strictly used for compiling survey statistics and will be treated as confidential.
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Questionnaire

Based on what you have read, do you agree with the opinion expressed in the following statements: (Please answer Yes or No)

  Yes No
1.The patient's doctor disregarded and neglected to act on medical information in his possession.
2.The doctors and nurses ignored the patient's critical health and the need for emergency measures.
3.The hospital failed to give the patient the proper standard of care and ensure timely treatment.
4.Doctors, nurses and hospitals who are negligent must be held accountable for their actions.
5.We need an organization to focus on neglectful care by hospitals, doctors and nurses, expose the problems and vigorously push for swift changes to be implemented in the system
Prime examples of health care neglect are listed below. Please check the ones you agree with
1. Doctors and nurses are negligent in caring for their patients when they:
Agree
a) haven't got a natural trait and the dedication for taking care of people
b) are unable to assess that a patient's health is critical and hence closer care is essential
c) don't properly communicate and work closely with one another
d) are unwilling to ask for and use information from the family doctor and family members
2. Hospitals endanger the health and well being of their patients due to:
a) undue lengthy delays and no prioritizing method in the Emergency and Admission areas
b) in Emergency, the more critically ill patients are not given extra care and attention
c) tests for patients are not properly scheduled and there is a lengthy wait time for the results
d) no system for monitoring patients' reaction from dietary intake which might be critical
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