Penny Brohn UK

Help change life with cancer. For good

Measure Yourself Concerns and Wellbeing (MYCaW) Follow Up Form (Counselling)

Meaningful Measures operates the licence for MYCaW and collects anonymised and non-identifiable data from all users around the world to create a database of anonymised concerns/symptoms/activities. This data collection helps organisations understand people’ needs. Your MYCaW data will be fully anonymised and sent securely ONLY to Meaningful Measures, for more information see their website: www.meaningfulmeasures.co.uk. If you have any questions or concerns please email research@pennybrohn.org.uk.

meaningful-measures

PBUK MYCaW 2 - Counselling
AccessPlanIT ID

Please tick the relevant boxes below so we can understand more about the data collection:

I am a: (please select) *
This was completed: (please tick) *

Look at the concerns that you submitted last time.
Please rate to show how severe each concern or problem is now:

Concern or problem 1
(0 = Not bothering me at all and 6 = Bothers me greatly) *
Concern or problem 2
(0 = Not bothering me at all and 6 = Bothers me greatly)

How would you rate your general feeling of wellbeing now? (How do you feel in yourself?)

Wellbeing
(0 = As good as it could be and 6 = As bad as it could be) *

Other things affecting your health

What has been most important for you?

Measure Yourself Concerns and Wellbeing 2020 © Meaningful Measures Ltd

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