Patient Nutrition Screening Tool - Cancer Care

Nutrition and monitoring your weight is an important part of your treatment. The Oncology Day Therapy Unit has recently introduced this tool for nutrition screening.

Please complete this each time you attend the unit (or only weekly if more frequent visits). Scroll down below to complete and press submit when you are done.

If you have any other concerns, please contact the Nutrition & Dietetics department on 3646 3318.

Collection notice

Queensland Health (QH) is required to manage your personal information in accordance with the Information Privacy Act 2009 and the Hospital and Health Boards Act 2011, Part 7 Confidentiality. QH is collecting the personal information on this form to assist with identifying those who are at risk of poor nutrition and benefit from a dietitian review. This data will be checked infrequently. If you have any immediate health concerns please contact your doctor or other healthcare provider. In an emergency go to a hospital or call Triple Zero (000). Your information will be disclosed without your consent, if authorised or required by law. For further information about privacy and your health record please ask for a copy of the Queensland Health Privacy Brochure or visit www.health.qld.gov.au.