Living Now Newsletter Survey

Please answer the following questions about the post-transplant newsletter Living Now. We need your feedback to make our materials as helpful as possible.

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* 1. Who reads your Living Now newsletters? (Check all that apply)

Patient

Caregiver

Family

Friends

No one

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* 2. Do you save the newsletters to read again?

Yes

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* 3. Would you read Living Now online?

Yes

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* 4. As you consider the Living Now newsletters you have received, how useful were the following topics and features:

	Very useful	Useful	Not useful	Did not read
Health concerns (e.g., signs of infection or GVHD)	Health concerns (e.g., signs of infection or GVHD) Very useful	Health concerns (e.g., signs of infection or GVHD) Useful	Health concerns (e.g., signs of infection or GVHD) Not useful	Health concerns (e.g., signs of infection or GVHD) Did not read
Emotional concerns (e.g., depression, coping styles)	Emotional concerns (e.g., depression, coping styles) Very useful	Emotional concerns (e.g., depression, coping styles) Useful	Emotional concerns (e.g., depression, coping styles) Not useful	Emotional concerns (e.g., depression, coping styles) Did not read
Medication information	Medication information Very useful	Medication information Useful	Medication information Not useful	Medication information Did not read
Lifestyle choices (e.g., diet, relaxation techniques)	Lifestyle choices (e.g., diet, relaxation techniques) Very useful	Lifestyle choices (e.g., diet, relaxation techniques) Useful	Lifestyle choices (e.g., diet, relaxation techniques) Not useful	Lifestyle choices (e.g., diet, relaxation techniques) Did not read
Personal relationships	Personal relationships Very useful	Personal relationships Useful	Personal relationships Not useful	Personal relationships Did not read
Caregiving	Caregiving Very useful	Caregiving Useful	Caregiving Not useful	Caregiving Did not read
Post-transplant resources	Post-transplant resources Very useful	Post-transplant resources Useful	Post-transplant resources Not useful	Post-transplant resources Did not read
Patient photos and quotes	Patient photos and quotes Very useful	Patient photos and quotes Useful	Patient photos and quotes Not useful	Patient photos and quotes Did not read

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* 5. Do the newsletters help you have better conversations with your medical team?

Yes

Not sure

Not applicable

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* 6. Would you recommend Living Now to others in your situation?

Yes

Not sure

Other (please specify)

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

Yes

Not sure

Other (please specify)

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

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* 8. Patient is:

Male

Female

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* 9. Patient’s age:

0–17 years

18–30 years

31 to 50 years

51 years and older

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* 10. Patient’s ethnicity:

Hispanic or Latino

Not Hispanic or Latino

Decline to answer

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

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Decline to answer

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* 12. Patient’s highest level of education:

High School diploma

Associate degree

Undergraduate or Bachelor degree

Graduate or Doctoral degree

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* 13. Additional comments or suggestions (e.g., other survivorship topics of interest):

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* 14. Would you be interested in receiving results of the Living Now survey?

Yes, via e-mail. (Provide your email address below.)

Yes, via U.S. mail. (Provide your full mailing address below.)

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* 15. Are you interested in sharing your post-transplant experience with other patients and families?

No, not at this time.

Yes, please send me the transplant journey questionnaire. (Provide contact information below.)

Your contact information, including full mailing address, phone number and email address: