Distress and supportive care for carers

Identify your concerns - ONLY complete this before your planned telehealth appointment

It can be hard to know what you need help with. To understand how we can best support you, we use the Distress Thermometer and Supportive Care Needs Survey – 6. The Distress Thermometer shows how much distress you are feeling. The Supportive Care Needs Survey - 6 helps us know what else you may have concerns about.

Please enter your name, date of birth and postcode, then choose your distress level, and tick any items you have concerns with. When you press Submit, your answers will be sent to the Support Specialist you have an appointment with.

Pancare Foundation doesn't provide crisis or emergency medical support. If you need immediate mental health support please contact Lifeline on 13 11 14 (24-hour service) or contact your treatment team or GP for support with your physical health.

First Name

Last Name

Date of Birth

Postcode

Please click the number (0-10) that best shows how much distress you have been feeling in the past week including today.

Please tick if any of the following have been a problem for you in the past month including today.

The impact that caring for the person with cancer has had on your working life, or usual activities.

Getting emotional support for yourself.

Understanding the experience of the person with cancer.

Having the opportunity to discuss your concerns with the doctors.

Accessing information relevant to your needs as a carer.

Accessing information on what the person with cancer’s physical needs are likely to be.

Other concerns