Concentric digital consent feedback

Example template

This is an example template and can be modified to your own questions should you wish.

Concentric is the digital consent application being used at , and aims to support you in making decisions about treatment.

You have received this survey link from your clinician because you have given your consent to treatment digitally, either in person with your clinician or remotely.

Your responses will not impact your care. To find out more about Concentric, you can visit the Concentric website.

How satisfied were you with the Concentric digital consent process?

What is the one thing that could be improved on?

This could be an improvement to the consent process or an improvement to the Concentric application.