Wednesday Patient & Caregiver Survey

Question Title

* 1. How was your overall experience today? Please rank from 1 as poor to 5 as outstanding.

Question Title

* 2. How did you hear about the conference?

CCF Website

Email from CCF

Social Media

Discussion Boards

CCF Webinars/Support Groups

Referred from Provide/Institution

Other patients or caregivers

Other (please specify)

Question Title

* 3. What is your connection with the Cholangiocarcinoma Foundation? (check all that apply)

Patient

Volunteer

Nurse

Researcher

Industry Partner

Other (please specify)

Question Title

* 4. How often do you visit the CCF website?

Daily

Weekly

Monthly

Occasionally

Yearly

Never

Question Title

* 5. Do you need help? Please check all that apply

Nutritional Support

Emotional Support

Connection with a mentor

Second opinions

Understanding you biomarker testing

Organizing your health records

Contributing to research

General wellness

Getting connected on social media

Financial support information

Question Title

* 6. If yes, please provide your contact information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number