Warrior Wellness Check-In

Warrior Wellness Check-In

Surrounding women undergoing cancer treatment with a supportive, empowering sisterhood.
Hey Sis! 🌸
This check-in is a way to honor where you are today — no judgment, no pressure.
Whether you are filling this out for yourself or reflecting for your Little Sister, thank you for helping us walk this journey together with love and support.

Take a moment just for you. 💖
This space is yours to reflect, breathe, and share honestly about how you're feeling.
There are no wrong answers — only your truth.
We are here to listen, uplift, and walk with you every step of the way.
You are powerful. You are not alone. You are a Warrior.
Who is completing this form today?*

I am a Big Sister completing this based on my check-in conversation.I am a Little Sister completing this for myself.
Your Name *

First NameLast Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Name of Little/Middle Sister, if applicable.
No Changes?

Check if nothing has changed since your last check-in.

How are you feeling in these areas today?*

	Really having a hard time	Struggling a bit	Hanging in there	Doing well most days	Feeling strong and steady
My appetite and ability to nourish myself
My emotional well-being and mood
My level of worry or anxiety
My financial situation
My housing and transportation stability
My family and support system connections
My understanding of my treatment plan and next steps

Appetite
Emotions
Worry
Finance
Housing/Transportation
Treatment
Support
Wellness Score
Your voice matters.

Would you like to share anything more with us?
Physical challenges or symptoms you are facing:
Anything else you’d like us to know today?
One strength, hope, or blessing you're holding onto today:
Would you like someone from our Sister Support Team to connect with you?

Big Sister (Peer Mentor for one-on-one support)Financial Wellness Advisor (Help with insurance, bills, resources)Mental Health and Wellness Partner (Emotional support check-in)Nutrition and Wellness Support (Eating well during treatment)Chaplain/Spiritual Care Partner (Spiritual encouragement)No follow-up needed right now — I'm okay for now.Other
🌸 Our Promise to You:

Everything you share is treated with compassion, respect, and confidentiality.
If your responses show that you might need extra support, a member of our Sister Support Team may reach out to you.

We are here to walk beside you — never to pressure you, only to uplift and support you.
If MySKCle needs to follow up with you based on your answers, how would you like us to reach you?*

Phone CallText MessageEmailPlease do not contact me at this time
By submitting this check-in, I understand that My Sister’s Keeper-Cleveland may contact me based on the contact method I selected.
Should be Empty:

Your voice matters.