Group Loop Survey

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1. How old are you?

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How old are you?

2. What is your cancer connection?

What is your cancer connection?   I have cancer A family member has cancer A friend has cancer

Other (please specify)

3. If you are a cancer patient, are you still in active treatment?

If you are a cancer patient, are you still in active treatment?   Yes No N/A

4. How did you learn about Group Loop?

How did you learn about Group Loop?   Gilda's Club The Wellness Community Cancer Support Community Online Family Member Friend Social Worker

Other (please specify)

5. Why did you log onto Group Loop?

Why did you log onto Group Loop?   To receive support from others To learn new information about cancer To feel less alone To provide support for others To unburden myself To connect with other teens

Other (please specify)

6. Was this site easy to use?

Was this site easy to use?   Yes No

Please Explain

7. Did you find what you were looking for?

Did you find what you were looking for?   Yes No

Please Explain

8. Would you be interested in being a featured teen on this site?

Would you be interested in being a featured teen on this site?   Yes No

If yes, please provide your email address so we can contact you:

9. Where did you spend most of your time on the site?

Where did you spend most of your time on the site?   Online Support Groups Discussion Boards Info Zone In the Loop Cancer, School and You Teens Talk 2 Teens Blog Instant Messenger

10. Do you use any of the following sites:

Do you use any of the following sites:   Facebook Twitter Care Pages Caring Bridge My Cancer Lifeline.org Cancer-Specific Sites

Other (please specify)

11. If you are interested in being entered to win a $20 iTunes gift card, please provide your contact information. In order to be eligible for the gift card, you must answer all questions. Winners will be picked monthly and notified by email.

*Apple is not a participant in or sponsor of this promotion*

If you are interested in being entered to win a $20 iTunes gift card, please provide your contact information. In order to be eligible for the gift card, you must answer all questions. Winners will be picked monthly and notified by email. *Apple is not a participant in or sponsor of this promotion*   Full Name:
Phone Number:
Email Address:

12. Additional Comments:

Additional Comments: