Regional, Rural and Remote- the Patient Experience Question Title * 1. What is your postcode? Question Title * 2. Are you male or female? Male Female Prefer not to say Question Title * 3. What is your email address? Leave blank if you would prefer not to disclose Question Title * 4. What is your lymphoma subtype? examples include DLBCL or Follicular Lymphoma If your subtype isn't listed, please type in the bottom box or type unknown NHL Hodgkin's DLBCL Follicular CLL/ SLL Mantle Cell Lymphoma Marginal Zone Lymphoma T cell lymphoma CNS lymphoma Other subtype (please specify) Question Title * 5. What hospital or health clinic do you go to for treatment or checkups related to your lymphoma? If you are not attending a hospital or clinic, please type unknown. Question Title * 6. Do you have a local rural treatment centre that you have received treatment at? Yes, I received ALL of my treatment at my rural centre Yes, I have received SOME treatment at my rural centre Yes, there is a local treatment centre but I HAVEN'T received any treatment there No, there is not a rural treatment centre Other (please specify) Question Title * 7. Select the most suitable option to describe your situation. Are you currently: receiving active treatment on watch and wait remission post treatment getting ready to start treatment unsure Question Title * 8. How far do you need to travel one way to see your lymphoma specialist? Less than 100km Less than 200km Less than 300km Less than 400km More than 400km Other (please specify) Question Title * 9. Have you used phone or video telehealth with your lymphoma specialist at any point? phone only video only phone and video none of the above Did you find telehealth helpful/ meaningful? Question Title * 10. Did, or do you have a partner, friend or family member that you could rely on during treatment? Yes No Other (please specify) Question Title * 11. How long ago were you diagnosed Less than 1 year Less than 5 years Less than 10 years More than 10 years ago Other (please specify) Question Title * 12. What supports were you offered at diagnosis? (select all that apply) Information about lymphoma Treatment education Referral to Lymphoma Australia Referral to allied health professionals like a dietitian or social worker Financial support Information about support groups Information about patient facebook groups Referral to other support organisations, similar to Lymphoma Australia Travel subsidies Accommodation support Other (please specify) Question Title * 13. When you were diagnosed did you find that your informational needs were met? I had too much information I had a good understanding of my treatment and lymphoma I was not given enough information Don't know Other (please specify) Question Title * 14. When you were first diagnosed, did you look for more information on your lymphoma or its treatment, than what you got from the doctors and nurses caring for you? Yes No Can't remember Prefer not to say What extra information were you searching for? Question Title * 15. Have any of the following prevented you from receiving treatment? (select all that apply) Financial difficulties Too far to travel Had to work Access to transport Distance from treatment centre Access to the most up to date treatment Language barriers Treatment waiting times List any other barriers here? Question Title * 16. Do you think your treatment options are different compared to someone with the same type of lymphoma living in a big city? Definitely Maybe Absolutely not Unsure Comment below Question Title * 17. In your own words, what has been your biggest challenge in managing your lymphoma or CLL while living regional, rural or remotely? Question Title * 18. Would you, or did you have to leave home for treatment and travel to big city hospitals? Yes Maybe No If you selected no you wouldn't travel or maybe you wouldn't, can you please tell us why? Question Title * 19. Have you been offered a clinical trial? Yes No If you have been offered a clinical trial, did you enrol? If not, why not? Question Title * 20. Please select the option you would most likely choose, based on your personal choice and situation. When discussing treatment options, I would choose: a treatment option that kept me closer to home, even if it was less effective the most successful treatment option, even it meant I had to travel and be away from home for long periods of time. Can you briefly explain your choice? Question Title * 21. How did you find out about Lymphoma Australia? (select all that apply) Internet search Health Professional referral Printed book Waiting Room flyer Word of mouth Other (please specify) Question Title * 22. Do you consent to further contact from Lymphoma Australia, to help with further initiatives in the regional, rural and remote locations? Yes No If you have further questions or require support, please contact our Lymphoma Australia nurse teamEmail: firstname.lastname@example.org Phone: 1800 953 081 Click to Submit.