Living Better with Cancer This form is only for patients REGISTERED at Haddenham Surgery.Name First Last Date of BirthPhone NumberPlease leave a day time telephone numberAddress Street Address We also need the first line of your address.This support tool is designed to help you and your family and carers think about how things are at the moment and share any ideas you have that you think would help you to live better with cancer.Please take time to think through the questions and send us your thoughts and ideas. Someone from the surgery will then contact you to discuss your suggestions.How do you feel you are coping at the moment? I am not coping so well I am doing OK I feel wellDo you have any concerns?We know that some of these things can be important to people living with cancer. Please tick any that concern you at the moment. I don't have any concerns at the moment Support for my family or carers Lack of control, feeling down or stressed Likely treatment choices, prognosis and the future Work, finances or housing Lifestyle, social isolation, eating or drinking Mobility, travelling for appointments or treatmentFurther comments on your concernsIs there anything that you feel isn't working so well?There might be some areas where you feel that things could be better. Tell us about your relevant thoughts and ideas.How can things be improved?Is there anything else you wish to discuss or questions you would like answered?PhoneThis field is for validation purposes and should be left unchanged. Thank you for contacting us. We will be in touch shortly.