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Please help us better serve young adults affected by cancer.
Fill out this questionnaire and send it to us with your comments.
Thank you!
Did you find this Guidebook useful? :
Comments:


What parts did you find helpful? (Please check all that apply.)

Start With An Education:
The Folks In The White Coats:
Some Record Keeping Help:
Reactions And Actions:
The People In My Life:
A Parent's Perspective:
Comments:
What would you like to see added to this Guidebook?:
How would you rate your current quality of life?:


Where did you obtain this Guidebook?
Doctor's Office :
Social Worker's Office :
Other:


Where are you in your cancer experience?
Diagnostic Stage:
Treatment:
Immediate Post Treatment :
Long Term Post Treatment :
Other:


When in your cancer experience did you receive this Guidebook?
Diagnostic Stage:
Treatment:
Immediate Post Treatment :
Long Term Post Treatment :
Other:


When in your cancer experience did you find it most useful?
Diagnostic Stage:
Treatment:
Immediate Post Treatment :
Long Term Post Treatment :
Other:


On a scale of 1 (not useful) to 5 (very useful), how helpful was this Guidebook in the following areas
Deciphering the Diagnosis:
The Search for Information:
Treatment Decisions:
Dealing With Medical Practioners:
Dealing With Emotions:
Dealing With Relationships:


Optional Information
You are a:
Age:
Relationship to Survivor:
Diagnosis (if Survivor):
Age at Diagnosis(if Survivor):


Personal Information: (optional)

Name:
Email Address:
Phone:
Address:




I would like to join the Ulman Cancer Fund for Young Adults/Survivors/Loved Ones Network:
E-mail Address (required):

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DISCLAIMER: Information provided by the Ulman Cancer Fund for Young Adults (UCF) via this website is not intended to replace or supersede information received from medical, legal, or other professionals with regard to specific circumstances and concerns. UCF information is intended solely as a general resource. A licensed/certified professional should always be consulted regarding any medical, legal, or other pertinent issue regarding cancer diagnosis and treatment. The UCF accepts no responsibility or liability resulting from the use of information provided on this site.
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