Risk and Benefit Questionnaire for Breast Imaging

Were you given enough information about the risks and benefits of radiation before your mammogram? *

Yes

No

Have you read the posters or information sheet that was either handed to you or available on display in the waiting rooms which describe the benefits and risks associated with your mammogram? *

Yes

No

I did not see any posters/information leaflets

If you did read the posters or information sheets, did you find them easy to understand? *

Yes

No

Do you have any comments or suggestions on the information provided?

Did you have an opportunity to discuss any questions about the risks and benefits of having an x-ray with the Doctor before your mammogram? *

Yes

No

If you had any queries relating to your mammogram, did you have an opportunity to discuss them with the mammographer before your mammogram? *

Yes

No

Any further comments?

*

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Risk and Benefit Questionnaire for Breast Imaging