Cancer Survivor 2-Minute Survey

"A wise man should consider that health is the greatest  of human blessings, and learn how by his own  thought to derive benefit from his illnesses."  —Hippocrates

Hi. I'm Michael Lepage, a cancer survivor like you. I want to say thank you for taking a few minutes to help with some research. This survey is how I figure out where survivors have the most pain and need the most help. Please complete the survey below, answering as best you can.

What is your gender?: *

Male

Female

How old are you?: *

When were you first diagnosed with cancer? (yyyy/mm): *

What type of cancer were you diagnosed with?: *

Are you still in treatment?: *

Did you pursue any alternative therapies to heal from cancer?: *

I pursued ONLY alternative therapies

I pursued ONLY standard medical treatments (chemo, radiation, etc.)

I tried a bit of both, but mostly standard medical treatments

I tried a bit of both, but mostly alternative therapies

I've used both equally

I have not pursued any therapies or treatments

How concerned are you of a relapse?: *

Very concerned

Somewhat concerned

Hadn't thought about it

Not concerned at all

Cancer and Money

What has been the financial impact of having cancer?: *

I'm in big-time debt because of my illness

I was already in big-time debt and getting sick didn't help

I'm not in debt, but I'm not raking in the dough either

I'm doing ok

I'm doing better than ever

Helping

To what degree has having cancer inspired you to help others?: *

I have a great desire to help

I really want to help but haven't found the right opportunity

I want to help, but I'm too busy

I think I want to help, but ....

I'm not really interested

If you have a great desire to help others, how would you like to help? Please elaborate.:

Cancer & Spirituality

Has having cancer changed your beliefs around spirituality?: *

Yes

If you answered Yes, can you briefly describe how?:

(Optional) Please provide your first name & email address - (used to send you a Thank You for completing the survey)

First Name:

Email:

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Cancer Survivor 2-Minute Survey

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