Needs Survey for those Touched by Breast Cancer

The mission of UnityPoint Health – Marshalltown Foundation’s Prevent Fund is to reduce the impact of breast cancer on the lives of Central Iowans. One way in which it does this is to pay for mammograms for women and men who cannot afford them.  The Foundation is interested in knowing what needs breast cancer patients and their families have as they go through treatment and beyond. If you have, or a loved one has, experience with breast cancer, would you please take a moment to share your thoughts with us? The goal is to identify and better understand your needs and the needs of your families. Please share any additional comments as you respond to the questions below. 

Thank you for your time and energy! For questions, please call UnityPoint Health - Marshalltown Foundation at 641-754-5005 or email us at

* 1. Contact information (optional)

* 2. Which of these is true for you?

* 3. When I received my diagnosis, I felt I most needed:

* 4. When receiving treatment, I most need/needed:

* 5. The best way my friends have supported me:

* 6. I wish someone had done/would do this for me or my family:

* 7. I would do this for someone else who is newly diagnosed with breast cancer:

* 8. I would do this for someone else who is in treatment for breast cancer:

* 9. I would like to have access to local resources that could support:

* 10. What else would you like us to know?