BRAINMETSBC.ORG SurveyBRAINMETSBC.ORG Survey

While your responses will be completely anonymous, telling us a little bit about yourself will help us to make BRAINMETSBC.ORG better able to meet the needs of patients, caregivers, advocates and healthcare professionals.

Read the BRAINMETSBC.ORG Privacy Statement at
http://brainmetsbc.org/index.php?q=content/privacy-statement-brainmetsbcorg

1. Which of the following best describes you?

Which of the following best describes you? I have had or currently have breast cancer brain metastases (or other CNS metastases)

I'm a metastatic breast cancer patient who wants to learn about brain and CNS metastases

I'm a family member, caregiver or friend of someone with brain or CNS metastases

I'm a patient advocate

I'm a healthcare professional

Other (please specify)

2. How did you find the BRAINMETSBC.ORG website?

How did you find the BRAINMETSBC.ORG website? Searching online

Email announcement

BreastCancer.Net Newsletter

Breast cancer organization

Word of mouth

Mentioned in an online community

Magazine or other periodical

Conference

Other (please specify)

3. With what racial/ethnic group do you most identify?

With what racial/ethnic group do you most identify? White (Caucasian)

Hispanic

Black (African-American)

Asian-Pacific Islander

Other (please specify)

4. How old are you now?

How old are you now? 29 or younger

30-39

40-49

50-59

60-69

70-79

Over 80

5. How long has it been since you were first diagnosed with metastatic breast cancer? (Caregivers, please describe your family member)

How long has it been since you were first diagnosed with metastatic breast cancer? (Caregivers, please describe your family member) Doesn't apply to me (or family member)

Less than one year

1-2 years

3-5 years

6-10 years

More than 10 years

6. How long has it been since you were diagnosed with brain (or other CNS) metastases? Check all that apply.(Caregivers, please describe your family member)

How long has it been since you were diagnosed with brain (or other CNS) metastases? Check all that apply.(Caregivers, please describe your family member) Doesn't apply to me (or family member)

Less than one year

1-2 years

3-5 years

6-10 years

More than 10 years

I had brain metastases when I was diagnosed with breast cancer

I had brain mets as my first site of metastasis

BRAINMETSBC.ORG Survey

1. About you