Cancer Health_Winter_2018

Your Cancer Care
It’s estimated that around 1.6 million people in the United States will be diagnosed with cancer this year and about 40 percent of people will be diagnosed with cancer at some point in their life. Cancer Health wants to know how cancer affects you.
1) Have you ever been diagnosed with cancer?
2) Has anyone in your family been diagnosed with cancer?
3) If you have been diagnosed with cancer, what type was it?
4) How was your cancer discovered?

Other
5) Where are you in the diagnosis and treatment process?
6) What type of treatment have you received? (Check all that apply.)
7) What side effects have you experienced from your treatment? (Check all that apply.)

Other
8) Where do you get information about cancer treatment options? (Check all that apply.)
9) What types of support and services have you used? (Check all that apply.)

Other
10) What year were you born?
11) What is your gender?

Other
12) What is your sexual orientation?

Other
13) What is your ethnicity? (Check all that apply.)

Other
14) What is your zip code?
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Your Cancer Care