Breast reconstruction after cancer
 
Please take time to read the summary of the proposed policy.
 

* 1. The draft policy proposal would guarantee that patients, who have completed treatment for breast cancer, would be able to access reconstruction within five years of that treatment or seven years in the case of inflammatory breast cancer.

  Yes No Don’t Know
Do you understand this proposal?
Do you support this proposal?

* 2. The draft policy now includes access to clinical rebalancing surgery to the unaffected breast.

  Yes No Don't Know
Do you understand this part of the proposal?
Do you support this part of the proposal?

This flow chart has been designed to help understand the proposed policy and clinical pathway:

This flow chart has been designed to help understand the proposed policy and clinical pathway:

* 3. Does the flow chart help you understand this pathway?

* 4. Do you have any other comments?

* 5. What is the first half of your postcode? (e.g BS3 or BS24)

The information you provide below will help us improve the health of the whole local population. All information you provide will be treated anonymously and with utmost confidence.

* 6. Age

Disability

* 7. Do you consider yourself disabled?

* 8. It helps us to know whether we are reaching all disabled people. Please can you tick the relevant impairment (disability) group below, and you are welcome to tick more than one box if appropriate:

Gender reassignment

* 9. Have you gone through a gender reassignment process or do you intend to?

Pregnancy and Maternity

* 10. Are you pregnant, or have you given birth in the last 26 weeks?

Race

* 11. What is your ethnic group?

Religion and Belief

* 12. Do you have a Religion or Belief?

* 13. If yes, are you?

Sex

* 14. Are you:

Sexual Orientation

* 15. What is your sexual orientation

If you are happy to be contacted about this consultation, please enter your contact details below.

* 16. Email address

* 17. Phone number

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