Background: For patients undergoing radiation treatment for advanced cancer, coordination between multiple care teams is required. The radiation therapy care pathway is complex, with numerous components, including consultation, planning, treatment delivery, and follow up care. Fragmented care can result from suboptimal communication among referring providers and patients. Prior to initial consult with a radiation oncologist, many patients are unaware of the complex logistics, resulting in additional distress. We conducted a survey to determine how to improve communication to better prepare patients for radiation therapy. Methods: In a pilot project to address communication barriers for patients receiving radiotherapy, a brief 10-question multiple choice survey was developed to gather patient-reported data at the time of initial consultation for palliative or primary CNS radiation treatment. The survey addressed patient understanding of the indication, logistics, and expected outcomes and toxicity of radiotherapy. Results: Our preliminary data is gathered from 16 patients who filled out a survey at the time of consult. Of this group, 10 patients received palliative radiotherapy for advanced malignant disease. Ninety percent of patients were able to correctly identify the role of the radiation oncologist in cancer care. Only 30% demonstrated understanding of the logistics of radiotherapy, including details of planning and multisession treatment delivery. Several patients noted concerns about the logistics and expected efficacy of treatment. No patients were previously informed of the indication of radiotherapy for pain palliation. Conclusions: Initial survey results suggest that advanced cancer patients are often mis- or under-informed about their disease status and the indication of radiotherapy in treatment and palliation of symptoms. Improved communication with patients referred for radiation therapy consultation may alleviate their concerns and enable them to set appropriate expectations for subsequent radiotherapy, minimizing distress. Ongoing survey results will be utilized to identify opportunities to educate providers towards better patient communication.