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Holistic assessment and care planning for breast cancer patients

Having cancer can affect many areas of your life. Please complete the following assessment towards the end of your treatment. Care plans are part of your treatment pathway.

This form is only available to patients of West Suffolk NHS Foundation Trust. If you are not on our records, unfortunately we will not be able to respond to your query. If you received your treatment elsewhere and require assistance, please contact your GP or the oncology team where you received treatment.

The assessment takes about 5 minutes to complete. It may be helpful to do it with someone who knows you well. It will really help us to understand any issues, concerns and feelings that you have as well as identify any information and support that you may need.

If any of the issues below are causing you concerns please tick the box.

  • Name
  • Physical concerns
  • Practical concerns
  • Spiritual or religious concerns
  • Family/relationship concerns
  • Emotional concerns
  • Lifestyle or information needs