How did you hear about 2Live2Cure? *

Social Media

Facebook

Instagram

Web Search

Direct visit to 2Live2Cure.org

Word Of Mouth

Cancer Care News

A hospital or social worker

Another cancer patient

Other Referral

Facebook Group

Phone / Text

I want to be notified of upcoming events and 2Live2Cure survey opportunities. By entering my phone number I understand I may be called or texted for survey follow up or to be notified of upcoming events.

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Age *

Under 18

18-24

25-30

31-35

36-40

41-45

46-50

51-55

56-60

61-65

66-70

70+

Gender *

Male

Female

Non-Binary

Prefer not to say

Other

Ethnicity *

American Indian

Black

Asian

White

Hispanic/Latino

Pacific Islander

Mixed Race

Prefer not to say

Other

How far do you travel for care each way?

1-10 Miles

11-50 Miles

51-100 Miles

100+ Miles or more

Have you met with a social worker or patient navigator at your clinic?

Yes

No

Unsure

Are finances a barrier to receiving care?

Yes

No

Sometimes

Is time a barrier to receiving care?

Yes

No

Sometimes

How often do you travel for medical care?

1 time per week

2 times per week

3+ times per week

1 time per month

2-3 times per month

Have you been offered support services or information about programs offered at your hospital?

Have you been offered support services or information about programs offered at your hospital? ie; support groups, wellness activities, or care kits.

Yes, I have been offered information on available programs

No, I have not been offered information on available programs

No, but I would like to receive information on available resources

I have received a cancer care kit at my hospital

I have not received a cancer care kit from my hospital

Would you be more or less likely to attend classes, support groups, or events if they were held online?

No, I would not be more likely to attend events online

Yes, I would like to attend events online

I like to attend events in person

I would not like to attend additional events

How do you look for cancer patient resources?

I rely on hospital staff to help me find resources

I look online for available resources

I use social media to find support services

I rely on friends or family members

Since your cancer diagnosis, have you been able to participate in any personal wellness activities?

Yoga/Exercise Class - (online)

Yoga/Exercise Class - (in-person)

Nutritional Services - (tele-health)

Nutritional Services - (in-person)

Support group meetings - (in-person)

Support group meetings - (online)

Journaling or Sketching

Facials/Spa Services

Massage

Acupuncture

Chiropractic

Meditation

Therapy

None

Other

Since your cancer diagnosis, have you made any changes to your lifestyle?

Yes

No

Some

Added exercise to my routine

Changed my eating/dietary habits

Changed work environment

Changed social activities

Started Therapy

Attended Support Groups

Limited Social Contact

If you made changes to your routine since your diagnosis, have these changes been positive?

Yes

No

Somewhat

What support services or programs do you currently use at your hospital?

Exercise/Yoga Classes

Support Groups

Massage

Facials/ Spa Services

Lymphedema Massage

Meal Services

Gym Privileges

Financial Aid Programs

Mental Health Support

Physical Therapy

None

Other

Do you feel like you have the support you need to manage your cancer care?

Yes, I feel I have enough support.

I could use more support managing daily activities at home.

I would be interested in additional non-medical support services.

I would be interested in additional support services offered by my local clinic or hospital.

What cancer support services would you like to see offered in your area? Check all that apply

Massage Services

Care Kit - (in clinic)

Care Kit (mailed to home)

Yoga/Exercise Class - (online)

Yoga/Exercise Class - (in-person)

Meal Service - (delivered home)

Meal Service - (pick-up local restaurants)

Nutritional Services - consultation

Facials/Spa Services or Products

Support group meetings - (in-person)

Support group meetings - (online)

Medical Transportation

Fuel or Gas Card

Art Classes

House Cleaning Services - (at home)

Financial Aid Services

State and Federal program assistance

CBD information

State Medical Marijuana Programs