| Sex: |
Female
Male |
| Race: |
|
| Age at Diagnosis: |
|
| Current Age: |
|
| Highest Education Level: |
|
| What is your relationship to the patient? |
|
| Have you (or the patient) ever been offered survivorship
health information before?
No
Yes |
| Who is currently managing your healthcare needs? |
If Other, Please specify:
|
| What is your geographical location? |
USA
Canada
Other Country
|
Coping with Cancer