Cancer Care in the COVID-19 Pandemic (U.S. PROVIDER SURVEY)

Cancer Care in the COVID-19 Pandemic (U.S. PROVIDER SURVEY)
Cancer Health wants to know how the COVID-19 pandemic has affected your organization. We plan to aggregate and share your responses to show how the COVID-19 pandemic has impacted cancer care and services. Thank you for completing the following survey.
Severely affectedModerately affectedSlightly affectedHas not affected
YesNo
Alternative and Holistic TherapiesCounseling or Treatment ServicesFinancial AssistanceFood/MealsHospice ServicesHotlinesHousing ServicesInsurance AssistanceLegal AssistanceMental Health AssistancePeer/Group SupportReferral ServicesSenior ProgramsSubstance Abuse Counseling or TreatmentTransportation AssistanceYouth ProgramsOther
EmailHome visitsSocial mediaTelephoneTextsOther
YesNo (Skip to question 7.)
6) If yes, what platform are you using?
Very concernedModerately concernedSlightly concernedNot concerned
YesNo
ClinicCommunity-Based OrganizationComplementary TherapyDoctorDrug Treatment CenterEducational InstitutionFaith-Based OrganizationGovernment-Based Organization (e.g., State, County or City)Grant FoundationHospitalHousing ProviderLegal CounselPharmacyOther
LocalStatewideNationalInternational
YesNo
YesNo
YesNo
14) In what state are you located?
15) What is your biggest concern for your clients?
16) What is your biggest concern for your organization?
17) Which aspect of your operation is most affected by COVID-19?
18) Is there anything specific we can help you with? (Please include organization name, contact person and email address.)
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