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Making a decision together

Name:    Age:   Today’s date:

Are you the:      Hospital number or date of birth (if known):

Please answer the questions below Yes

Smiley face like

No

Unhappy smiley face

Not sure

Okay straight face smiley face

hand reaching for one of three balls, meaning a choice My healthcare team said we need to make a decision
Person pointing to themselves My healthcare team said I should be involved in making the decision
hand reaching for one of two balls, meaning a choice My healthcare team told me about the different choices
thumb up and thumb downMy healthcare team explained what was good and bad about the choices
know and understandMy healthcare team helped me understand the information

  Yes

Smiley face like

No

Unhappy smiley face

Not sure

Okay straight face smiley face

a heart and a thumbs upMy healthcare team asked me about which choice I liked
two people talking to each otherMy healthcare team and I discussed the different choices
a face and a hand pointing to a thought bubble with one ball inside, indicating a choice they have madeMy healthcare team and I made a decision together
A list from 1 to 5My healthcare team and I made a plan about the decision
large letter i indicating informationThe information I was given was useful to help make the decision

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Disclaimer

Please note: this is a generic information sheet relating to care at Sheffield Children’s NHS FT. These details may not reflect treatment at other hospitals. This information is not intended as a substitute for professional medical care. Always follow your healthcare professionals’ instructions. If this resource relates to medicines, please read it alongside the medicine manufacturer’s patient information leaflet. If this information has been translated into another language from English, efforts have been made to maintain accuracy, but there may still be some translation errors. If you are unsure about any of the guidance in this resource or have specific questions about how it relates to your child, always ask your healthcare professional for further advice.

Resource number: GEN4

Resource Type: Article

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NHS

Western Bank
Sheffield
S10 2TH

United Kingdom

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