We are conducting research regarding the safety and quality of take-home cancer medications and would appreciate your participation in a brief survey. The CanCertainty Coalition is the united voice of 35 Canadian patient groups, cancer health charities, and caregiver organizations from across the country, joining together to significantly improve the affordability, accessibility and safety of cancer treatment.   You must be a Canadian resident to participate in this survey.

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* 1.  How would you describe yourself? Are you…

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* 2. If given the choice between two equally effective medications for cancer, which would you personally prefer?

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* 3. Given the choice of a take-home medication, where would you prefer to have your first prescription of cancer
drugs dispensed?

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* 4. For renewals of the prescription cancer medication, where would you prefer to have the drugs dispensed to
you?

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* 5. Do you agree or disagree with the following statement. Patients who take their cancer medications at home
should be monitored and supported by cancer-trained healthcare providers in the same way as those who take
their medications in-hospital.

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* 6. Which of the following age groups best describes you?

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* 7. Are you male or female?

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* 8. (FOR PATIENTS AND CAREGIVERS ONLY) Would you be willing to be contacted about your experience with take-home cancer medications?

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* 9. Would you like to receive updates on take-home cancer drugs coverage from the CanCertainty Campaign ?

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* 10. If you answered "Yes" to Question 8 or 9, please provide your email address.

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