Feedback on clinical trials | Queensland Eye Institute

Name

This field is for validation purposes and should be left unchanged.

Please only one survey response per participant

1. Are you a participant or a carer of a participant taking part in the clinical trial?

Participant
Carer

2. Please select your age range (years)*

3. What is your gender?

Male
Female
Intersex
Transgender / non-binary
I prefer not to say

4. Are you of Aboriginal and/or Torres Strait Islander origin?*

Yes, Aboriginal but not Torres Strait Islander
Yes, Torres Strait Islander but not Aboriginal
Yes, both Aboriginal and Torres Strait Islander
Neither Aboriginal nor Torres Strait Islander
I prefer not to say

5. What is your ethnicity/family background?

This question is optional but helps us understand the cultural needs of our participants

6. Do you speak a language other than English at home as your primary language?*

Yes
No

7. What is your post code?*

This information helps us understand where our participants are coming from

The following questions relate to your experience as a Clinical Trial participant

8. I am treated with respect by my study doctor(s)*

This is the healthcare professional who is primarily responsible for your treatment

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Not applicable

9. I am treated with respect by members of the study coordinator team*

This could be your research nurse, or clinical coordinator who is involved in your clinical trial journey

Strongly disagree
Somewhat disagree
Neither agree nor disagree
Somewhat agree
Strongly agree

10. Reception areas are clean, private and easy to access*

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Not applicable

11. Waiting areas are clean, private and easy to access*

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree
Not applicable

12. My waiting time has been acceptable*

Yes
No
Not applicable

The following questions relate to your most recent visit to Queensland Eye Institute

13. What best describes your recent visit?*

First clinical trials visit
A routine CONSULT/TREATMENT visit
A routine FOLLOW UP visit (after treatment has finished)
Last clinical trial visit
Unsure

14. The trial process (when and how to take medicine/when and how I will be seeing my healthcare team/when and where my appointments will be) has been explained to me in a way that I understand

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

15. Information given to me before I joined the trial addressed everything I wanted to know (I was able to ask questions. I know who to contact with questions. I know the time commitments involved in this trial)

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

16. Information given to me before the trial was easy to understand (I know what the visits involve, who to contact and what the trial is for)

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

17. I was comfortable that I was able to ask questions before I joined the trial

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

18. What can we do to make it easier for you to ask questions?

19. Overall, I am satisfied with my clinical trial experience

Strongly agree
Agree
Neither agree nor disagree
Disagree
Strongly disagree

Thank you for your time. If you would like to discuss your feedback, please contact the QEI clinical trials unit on Tel: 3239 5001 or Email: clinical.trials@qei.org.au

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