Partnership Inquiry
General Information
Primary Contact Person
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First Name
Last Name
Email Address
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Phone
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Your Role
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Organization Name:
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Type of organization
Non-profit/Advocacy Org
Comprehensive Cancer Center
Outpatient Clinic
Integrative or Holistic Care Center
Hospital
Academic/Research Institute
Other
Please specify "Other" here
Department(s) represented (if relevant):
Number of (oncology-focused) staff in your institution/organization:
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1-40
41-150
151-500
500+
Would members of your staff benefit from having CE classes/credit available?
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Yes
No
N/A
Number of individual patients served annually by your organization (new and on-going cases):
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Under 500
500-2500
2500-10,000
10,000+
Any additional context you'd like to share (optional):
Primary Populations Served (Please check all that apply)
Patients currently undergoing cancer treatment
Cancer survivors
Partners/families of patients
Older adults (55+)
Adolescents / young adults (AYA)
LGBTQIA+ community
BIPOC communities
Palliative / end-of-life
Other (please specify)
Please specify "Other" here
Your Organization’s Aims
Which of the following aims is your organization currently prioritizing in survivorship or supportive oncology programming?(Select up to three.)
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Reducing clinician burden due to psychosocial, relational, and intimacy concerns
Increasing overall survivorship, satisfaction, and quality-of-life outcomes
Improving patient engagement, attention, or program completion rates
Differentiating our program within a competitive healthcare or nonprofit landscape
Meeting accreditation, compliance, or quality of care standards
Addressing sexual health or intimacy concerns that staff feel underprepared to manage
Expanding holistic or whole-person survivorship services
Strengthening staff confidence in navigating sensitive topics (ie. intimacy, body image, relationships, etc)
Developing scalable education resources without adding staffing strain
We are not currently prioritizing, sexual health or intimacy concerns
Other
Please share more:
Of the challenges selected above, which feels most urgent in the next 6–12 months?
Current Approach
Does your organization currently offer any training or education on intimacy, sexuality, relationship support, or body image for cancer patients?
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Yes
No
Not sure
Please share more:
Are there written policies, protocols, or guidelines addressing intimacy, sexuality, relationship support, or body image concerns in patient care?
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Yes
No
Not sure
Please share more:
Who is currently responsible in discussing intimacy, sexuality, relationship, or body image concerns with your patients? (Check all that apply)
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Presently no one formally
Oncologists
Nurses
Social Workers
Patient Navigators
Staff Psychologists / Sex Therapists
Other (please specify):
Please specify "Other" here
From your perspective, what are the biggest challenges your organization faces in addressing intimacy and body image in cancer care? (Check all that apply)
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Lack of provider training
Time constraints in patient visits
Discomfort in discussing these topics
Institutional policies
Patients don't bring it up, so it's not addressed
Lack of referral pathways or resources for patients
Other (please specify)
Please specify "Other" here
What are your current concerns or goals around these topics? (Check all that apply)
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Supporting patients' relationships and intimacy
Staff confidence talking about sex, body image, and identity
Creating inclusive language and intake forms
Improving psychosocial care for patients
Training new or existing staff
Developing patient education materials
Licensing premade tools/toolkits
Supporting partners/caregivers of patients
Creating a more trauma-informed culture at your organization
Addressing grief, loss, and identity shifts
Reducing provider burnout / increasing empathy skills
Other
Please specify "Other" here
Does your organization currently track patient satisfaction or concerns related to intimacy and body image in post-treatment surveys?
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Yes
No
Not sure
Interest in Consulting and Training
What type of support would your organization be most interested in? (Check all that apply)
Introductory talks for staff
Signature training for staff
Development of and/or licensing of PATIENT resources & education materials
Development of and/or licensing of STAFF resources & education materials
Institutional consulting to improve patient care strategies related to cancer and intimacy
Continuing Education (CE) courses/programs
Train-the-trainer programs
Special speaking engagement(s)
Enterprise-level licensing and organizational support
Other (please specify)
Please specify "Other" here
What is your anticipated annual budget for this work?
Under $5000
$5000 - $10,000
$10,000 - $25,000
$25,000 - $50,000
$50,000+
Budget not yet determined
Is there anything else you would like us to know?
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