Wellness and You
Wellness encompasses various aspects of your health and well-being. This includes your physical, mental, emotional, social, spiritual, occupational and intellectual health. Cancer Health wants to know how you maintain wellness in your life while living with cancer.
How long have you been living with cancer?
Less than a year
5–10 years
1–5 years
More than 10 years
I am now cancer-free.
How would you rate your overall wellness since your cancer diagnosis?
Excellent
Good
Fair
Poor
To what extent has cancer impacted your physical well-being?
Extremely
Moderately
Slightly
Not at all
Have you made any lifestyle changes to improve your physical health since your diagnosis?
Yes
No
To what extent has cancer impacted your emotional well-being?
Extremely
Moderately
Slightly
Not at all
Are you able to discuss your emotional concerns with your health care team?
Yes
No
Do you have a good support network?
Yes
No
Do you find healthy ways to manage your stress?
Yes
No
Does spirituality or faith play a role in your wellness journey?
Yes
No
Do you maintain a healthy work-life balance?
Yes
No
Do you regularly find ways to stimulate and challenge yourself mentally?
Yes
No
Do you regularly take time to unwind and relax?
Yes
No
What year were you born?
2026
2025
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
What is your gender?
Male
Female
Transgender
Other
What is your current level of education?
Some high school
High school graduate
Some college
Bachelor’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/Alaska Native
Arab/Middle Eastern
Asian
Black/African American
Hispanic/Latino
Native Hawaiian/Pacific Islander
White
Other
What is your ZIP code?
Please verify that you are human
*
Submit
Should be Empty: