Communcation Assessment Tool - Providers

Your answers to the following items will be kept strictly confidential and will be used only to assess the CHICOS program.

Please type your name

Please rate your ability to do the following things when communicating with families in Spanish:
 

Poor

Fair

Good

Very Good

Excellent
Greet the patient and family in a way that makes them feel comfortable
Treat the patient and family with respect
Show interest in the patient’s and family’s ideas about patient’s health
Understand the patient’s and family’s main health concerns
Pay attention to the patient and family (look at them, listen carefully)
Let the patient and family talk without interruptions
Give the patient and family as much information as they want
Talk in terms the patient and family can understand
Check to be sure the patient and family understand everything
Encourage the patient and family to ask questions
Involve the patient and family in decisions as much as they want
Discuss next steps, including any follow-up plans
Show care and concern
Spend the right amount of time with the patient and family