The Transplant Process Survey

Please answer the following questions about The Transplant Process. We need your feedback to make our materials as helpful as possible.

1. Who reads the information in The Transplant Process? (Check all that apply)

Who reads the information in The Transplant Process? (Check all that apply) Patient

Caregiver

Family

Friends

No one

2. Will you save The Transplant Process to read again?

Will you save The Transplant Process to read again? Yes

3. Does the information in The Transplant Process help you have better conversations with your doctor and medical team?

Does the information in The Transplant Process help you have better conversations with your doctor and medical team? Yes

Somewhat

Not sure

N/A

4. After reading The Transplant Process, do you have a better understanding of:

	Very much	Somewhat	Not at all	Did not read
The formal search for a donor or cord blood unit	*After reading The Transplant Process, do you have a better understanding of: The formal search for a donor or cord blood unit Very much	The formal search for a donor or cord blood unit Somewhat	The formal search for a donor or cord blood unit Not at all	The formal search for a donor or cord blood unit Did not read
Preparing for your transplant	Preparing for your transplant Very much	Preparing for your transplant Somewhat	Preparing for your transplant Not at all	Preparing for your transplant Did not read
Choosing a caregiver and understanding the caregiver role	Choosing a caregiver and understanding the caregiver role Very much	Choosing a caregiver and understanding the caregiver role Somewhat	Choosing a caregiver and understanding the caregiver role Not at all	Choosing a caregiver and understanding the caregiver role Did not read
Planning for transplant costs	Planning for transplant costs Very much	Planning for transplant costs Somewhat	Planning for transplant costs Not at all	Planning for transplant costs Did not read
Preparing emotionally for transplant	Preparing emotionally for transplant Very much	Preparing emotionally for transplant Somewhat	Preparing emotionally for transplant Not at all	Preparing emotionally for transplant Did not read
Addressing fertility concerns	Addressing fertility concerns Very much	Addressing fertility concerns Somewhat	Addressing fertility concerns Not at all	Addressing fertility concerns Did not read
Getting a central line	Getting a central line Very much	Getting a central line Somewhat	Getting a central line Not at all	Getting a central line Did not read
Preparative regimen treatment	Preparative regimen treatment Very much	Preparative regimen treatment Somewhat	Preparative regimen treatment Not at all	Preparative regimen treatment Did not read
Collecting cells for transplant	Collecting cells for transplant Very much	Collecting cells for transplant Somewhat	Collecting cells for transplant Not at all	Collecting cells for transplant Did not read
Receiving new cells	Receiving new cells Very much	Receiving new cells Somewhat	Receiving new cells Not at all	Receiving new cells Did not read
Preventing common complications	Preventing common complications Very much	Preventing common complications Somewhat	Preventing common complications Not at all	Preventing common complications Did not read
Returning home and staying healthy	Returning home and staying healthy Very much	Returning home and staying healthy Somewhat	Returning home and staying healthy Not at all	Returning home and staying healthy Did not read
One-year follow-up evaluation	One-year follow-up evaluation Very much	One-year follow-up evaluation Somewhat	One-year follow-up evaluation Not at all	One-year follow-up evaluation Did not read
Managing possible long-term effects	Managing possible long-term effects Very much	Managing possible long-term effects Somewhat	Managing possible long-term effects Not at all	Managing possible long-term effects Did not read
Contacting your donor	Contacting your donor Very much	Contacting your donor Somewhat	Contacting your donor Not at all	Contacting your donor Did not read
Adjusting to life after transplant	Adjusting to life after transplant Very much	Adjusting to life after transplant Somewhat	Adjusting to life after transplant Not at all	Adjusting to life after transplant Did not read

Comments:

5. After reading The Transplant Process, did you do any of the following? (Check all that apply)

After reading The Transplant Process, did you do any of the following? (Check all that apply) Did not read Mapping the Maze

Call the Office of Patient Advocacy (OPA) at 1(888) 999-6743 (toll-free)

E-mail OPA at patientinfo@nmdp.org

Visit our website at www.marrow.org

Contact another organization listed in the Resources section

Other (please specify)

6. Overall, how would you rate The Transplant Process?

Overall, how would you rate The Transplant Process? Very Good

Good

Fair

Poor

Very Poor

Please explain:

7. Would you recommend The Transplant Process to others in your situation?

Would you recommend The Transplant Process to others in your situation? Yes

Maybe

Don't know

Please explain:

8. Would you recommend the Office of Patient Advocacy to others in your situation?

Would you recommend the Office of Patient Advocacy to others in your situation? Yes

Maybe

Don’t know

I'm not aware of the Office of Patient Advocacy

Please explain:

For the following questions, please tell us about yourself. The information provided helps us understand your needs. All answers are confidential.

9. Patient is:

Patient is: Male

Female

10. Patient’s age:

Patient’s age: 0-10 years

11-17 years

18-30 years

31-40 years

41-50 years

51-64 years

65 years and above

11. Patient’s ethnicity:

Patient’s ethnicity: Hispanic or Latino

Not Hispanic or Latino

Decline to answer

12. Patient’s race (Check all that apply):

Patient’s race (Check all that apply): American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Don't know

Decline to answer

13. Patient’s highest level of education:

Patient’s highest level of education: High School diploma

Associate degree

Undergraduate or Bachelor degree

Graduate or Doctoral degree

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