Assessment of Workplace Action Choices
Exit this survey

Awareness – Information – Action - Resources

Cancer happens suddenly and it may affect an employee in your workplace. There is much that you can do to prepare. Please review some of the activity choices that are listed below and indicate those that you are currently doing, would like to do, or items for which you seek more information. Please note that there are many resources that are free of charge.

All answers are optional.

1. TOBACCO USE

	Already doing	Would like to do	Learn More	Not Interested
Post “Quit Smoking” posters	*TOBACCO USE Post “Quit Smoking” posters Already doing	Post “Quit Smoking” posters Would like to do	Post “Quit Smoking” posters Learn More	Post “Quit Smoking” posters Not Interested
Sponsor quit smoking program	Sponsor quit smoking program Already doing	Sponsor quit smoking program Would like to do	Sponsor quit smoking program Learn More	Sponsor quit smoking program Not Interested
Establish a smoke-free environment (inside & out)	Establish a smoke-free environment (inside & out) Already doing	Establish a smoke-free environment (inside & out) Would like to do	Establish a smoke-free environment (inside & out) Learn More	Establish a smoke-free environment (inside & out) Not Interested
Provide 100% insurance coverage for smoking cessation	Provide 100% insurance coverage for smoking cessation Already doing	Provide 100% insurance coverage for smoking cessation Would like to do	Provide 100% insurance coverage for smoking cessation Learn More	Provide 100% insurance coverage for smoking cessation Not Interested
Create workplace incentives for smoking cessation	Create workplace incentives for smoking cessation Already doing	Create workplace incentives for smoking cessation Would like to do	Create workplace incentives for smoking cessation Learn More	Create workplace incentives for smoking cessation Not Interested

2. SCREENINGS AND EARLY DETECTION

	Already doing	Would like to do	Learn More	Not Interested
Post information about important screenings	*SCREENINGS AND EARLY DETECTION Post information about important screenings Already doing	Post information about important screenings Would like to do	Post information about important screenings Learn More	Post information about important screenings Not Interested
Provide additional time off for screenings	Provide additional time off for screenings Already doing	Provide additional time off for screenings Would like to do	Provide additional time off for screenings Learn More	Provide additional time off for screenings Not Interested
Arrange for on-site screenings	Arrange for on-site screenings Already doing	Arrange for on-site screenings Would like to do	Arrange for on-site screenings Learn More	Arrange for on-site screenings Not Interested
Cost-share screenings and prevention vaccines	Cost-share screenings and prevention vaccines Already doing	Cost-share screenings and prevention vaccines Would like to do	Cost-share screenings and prevention vaccines Learn More	Cost-share screenings and prevention vaccines Not Interested
Cover screenings & prevention vaccines at 100%	Cover screenings & prevention vaccines at 100% Already doing	Cover screenings & prevention vaccines at 100% Would like to do	Cover screenings & prevention vaccines at 100% Learn More	Cover screenings & prevention vaccines at 100% Not Interested

3. CANCER AND THE ENVIRONMENT

	Already doing	Would like to do	Learn More	Not Interested
Provide information about cancer-related environmental hazards	*CANCER AND THE ENVIRONMENT Provide information about cancer-related environmental hazards Already doing	Provide information about cancer-related environmental hazards Would like to do	Provide information about cancer-related environmental hazards Learn More	Provide information about cancer-related environmental hazards Not Interested
Increase workplace use of environmentally friendly products	Increase workplace use of environmentally friendly products Already doing	Increase workplace use of environmentally friendly products Would like to do	Increase workplace use of environmentally friendly products Learn More	Increase workplace use of environmentally friendly products Not Interested
Assess air quality and take steps to improve it	Assess air quality and take steps to improve it Already doing	Assess air quality and take steps to improve it Would like to do	Assess air quality and take steps to improve it Learn More	Assess air quality and take steps to improve it Not Interested
Reduce toxins in the workplace	Reduce toxins in the workplace Already doing	Reduce toxins in the workplace Would like to do	Reduce toxins in the workplace Learn More	Reduce toxins in the workplace Not Interested
Sponsor workshops on how to reduce cancer risks in the workplace and home environments	Sponsor workshops on how to reduce cancer risks in the workplace and home environments Already doing	Sponsor workshops on how to reduce cancer risks in the workplace and home environments Would like to do	Sponsor workshops on how to reduce cancer risks in the workplace and home environments Learn More	Sponsor workshops on how to reduce cancer risks in the workplace and home environments Not Interested

4. HEALTHY LIFESTYLE BEHAVIORS

	Already doing	Would like to do	Learn More	Not Interested
Communicate information regarding healthy lifestyle behaviors	*HEALTHY LIFESTYLE BEHAVIORS Communicate information regarding healthy lifestyle behaviors Already doing	Communicate information regarding healthy lifestyle behaviors Would like to do	Communicate information regarding healthy lifestyle behaviors Learn More	Communicate information regarding healthy lifestyle behaviors Not Interested
Provide “lunch and learn” sessions on healthy lifestyle behaviors (e.g. nutrition, stress reduction)	Provide “lunch and learn” sessions on healthy lifestyle behaviors (e.g. nutrition, stress reduction) Already doing	Provide “lunch and learn” sessions on healthy lifestyle behaviors (e.g. nutrition, stress reduction) Would like to do	Provide “lunch and learn” sessions on healthy lifestyle behaviors (e.g. nutrition, stress reduction) Learn More	Provide “lunch and learn” sessions on healthy lifestyle behaviors (e.g. nutrition, stress reduction) Not Interested
Include insurance incentives for healthy lifestyle behaviors	Include insurance incentives for healthy lifestyle behaviors Already doing	Include insurance incentives for healthy lifestyle behaviors Would like to do	Include insurance incentives for healthy lifestyle behaviors Learn More	Include insurance incentives for healthy lifestyle behaviors Not Interested
Sponsor preventive care (e.g. subsidize gym membership, offer on-site nutrition consults)	Sponsor preventive care (e.g. subsidize gym membership, offer on-site nutrition consults) Already doing	Sponsor preventive care (e.g. subsidize gym membership, offer on-site nutrition consults) Would like to do	Sponsor preventive care (e.g. subsidize gym membership, offer on-site nutrition consults) Learn More	Sponsor preventive care (e.g. subsidize gym membership, offer on-site nutrition consults) Not Interested
Provide professional services in the workplace (e.g. stress reduction strategies, nutrition consultations, etc.)	Provide professional services in the workplace (e.g. stress reduction strategies, nutrition consultations, etc.) Already doing	Provide professional services in the workplace (e.g. stress reduction strategies, nutrition consultations, etc.) Would like to do	Provide professional services in the workplace (e.g. stress reduction strategies, nutrition consultations, etc.) Learn More	Provide professional services in the workplace (e.g. stress reduction strategies, nutrition consultations, etc.) Not Interested

5. WORKPLACE BENEFITS AND SERVICES

	Already doing	Would like to do	Learn More	Not Interested
Allow personalized work schedule	*WORKPLACE BENEFITS AND SERVICES Allow personalized work schedule Already doing	Allow personalized work schedule Would like to do	Allow personalized work schedule Learn More	Allow personalized work schedule Not Interested
Provide unpaid leave to patients and caregivers who have exceeded their earned PTO	Provide unpaid leave to patients and caregivers who have exceeded their earned PTO Already doing	Provide unpaid leave to patients and caregivers who have exceeded their earned PTO Would like to do	Provide unpaid leave to patients and caregivers who have exceeded their earned PTO Learn More	Provide unpaid leave to patients and caregivers who have exceeded their earned PTO Not Interested
Allow paid leave exchanges between employees	Allow paid leave exchanges between employees Already doing	Allow paid leave exchanges between employees Would like to do	Allow paid leave exchanges between employees Learn More	Allow paid leave exchanges between employees Not Interested
Provide insurance-based case management	Provide insurance-based case management Already doing	Provide insurance-based case management Would like to do	Provide insurance-based case management Learn More	Provide insurance-based case management Not Interested
Hire cancer management company	Hire cancer management company Already doing	Hire cancer management company Would like to do	Hire cancer management company Learn More	Hire cancer management company Not Interested

form {display:none;} #jserror {text-align:center;margin-top:50px;}Javascript is required for this site to function, please enable.