Caregiver Needs Survey

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* 1. My loved one with lung cancer is my

spouse/partner

parent

child

sibling

other realative

friend

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* 2. My loved one with lung cancer is

newly diagnosed and waiting for a treatment plan.

in treatment.

on a maintence plan.

not receiving treatment.

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* 3. What services or resources have been the most helpful to you as a lung cancer caregiver?

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* 4. What topics of caregiving are you interested in additional resources in?

mental health

burnout

financial planning

estate planning

sexual health

communicating with your loved one

home health services

assisted living options

Other (please specify)

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* 5. What type of caregiver support services would be most beneficial to you?

virtual meetups

one on one text support

one on one phone support

Facebook group

online forum

Other (please specify)

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* 6. Are you interested in joing the LifeLine Mentor Program?

I am looking to support caregivers as a mentor.

I am in need of support and would like to be matched with a mentor.

Not at this time.

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* 7. Please check all that apply.

I am interested in a newsletter for Caregivers.

I am interested in attending the COPE Summit this summer.

I am interested in receiving texts with caregiving tips and information.

I am interested in an app designed specifically for lung cancer caregivers.

I am interested in attending virtual meetups with other caregivers.

I am satisfied with the amount of lung cancer caregiver information and support that is currently available.

I need more resources and support services than are currently available.

Caregiver Needs Survey

Question Title

* 1. My loved one with lung cancer is my

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* 2. My loved one with lung cancer is

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* 3. What services or resources have been the most helpful to you as a lung cancer caregiver?

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* 4. What topics of caregiving are you interested in additional resources in?

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* 5. What type of caregiver support services would be most beneficial to you?

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* 6. Are you interested in joing the LifeLine Mentor Program?

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* 7. Please check all that apply.

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* 8. Are there any additional ways LUNGevity can support caregivers? Please share any additional information you would like us to know.