Cancer Health_Winter_2021

The Good Life
Quality of life is a subjective measure of one’s ability to comfortably enjoy one’s life. For people living with cancer, it can factor into treatment decisions. Please take our survey and let Cancer Health know about your quality of life.
How much do you worry about your health?

Very muchA moderate amountA littleNot at all
How much do you worry about your ability to access medical care?

Very muchA moderate amountA littleNot at all
Does physical pain ever prevent you from doing what you want to do?

YesNo
Do you get tired easily?

YesNo
Do you have any mobility issues?

YesNo
Are you satisfied with the quality of your medical care?

Very satisfiedSatisfiedNeither satisfied nor dissatisfiedDissatisfiedVery dissatisfied
Do you consider quality of life when making treatment decisions?

YesNo
Have you ever chosen a treatment because it would increase your quality of life?

YesNo
Have you ever declined a treatment because it would decrease your quality of life?

YesNo
How often do you experience feelings of despair, anxiety or depression?

AlwaysOftenSeldomNever
How often do you have trouble sleeping?

AlwaysOftenSeldomNever
Are you happy with your personal relationships?

Very happyHappyNeither happy nor unhappyUnhappyVery unhappy
How much do you worry about money?

Very muchA moderate amountA littleNot at all
Do you make time to enjoy your life?

YesNo
What year were you born?
What is your gender?

MaleFemaleTransgenderOther
What is your current level of education?

Some high schoolHigh school graduateSome collegeBachelor's degree or higher
What is your annual household income?

Less than $15,000$15,000-$34,999$35,000-$49,999$50,000-$74,999$75,000-$99,999$100,000 or more
What is your ethnicity? (Check all that apply.)

American Indian or Alaska NativeArab or Middle EasternAsianBlack or African AmericanHispanic or LatinoNative Hawaiian or other Pacific IslanderWhiteOther
What is your ZIP code?
Enter the message as it's shown*
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The Good Life