Checklist and Tip Sheet Wizard feedback form Survey

Question Title

1. Which checklist or tip sheet did you download? (Select all that apply).

Decision Checklist: Considering Mastectomy with or without Reconstruction

Tip Sheet: Mastectomy Preparation and Recovery

Decision Checklist: Considering Risk-Reducing Surgery for Ovarian or Endometrial Cancer

Tip Sheet: Gynecologic Surgery Preparation and Recovery

Checklist: Signs of an Inherited Mutation and How to Get Genetic Testing

Checklist: Genetic Testing for People Who Have Been Diagnosed with Cancer

Checklist: When to Consider Repeat Genetic Testing

I do not recall

Question Title

2. How did you learn about our tip sheets and checklists?

FORCE newsletter or social media post

FORCE support meeting or peer navigator volunteer

A healthcare professional

A link elsewhere on the FORCE website

Another advocacy group

A friend, relative or peer

From my training as a FORCE volunteer

I don't recall

Other (please specify)

	Strongly agree	Agree	Neither agree nor disagree	Disagree	Strongly disagree	Not applicable
It helped me prepare to have a conversation with my care team.	It helped me prepare to have a conversation with my care team. Strongly agree	It helped me prepare to have a conversation with my care team. Agree	It helped me prepare to have a conversation with my care team. Neither agree nor disagree	It helped me prepare to have a conversation with my care team. Disagree	It helped me prepare to have a conversation with my care team. Strongly disagree	It helped me prepare to have a conversation with my care team. Not applicable
It increased my confidence in my knowledge about my situation.	It increased my confidence in my knowledge about my situation. Strongly agree	It increased my confidence in my knowledge about my situation. Agree	It increased my confidence in my knowledge about my situation. Neither agree nor disagree	It increased my confidence in my knowledge about my situation. Disagree	It increased my confidence in my knowledge about my situation. Strongly disagree	It increased my confidence in my knowledge about my situation. Not applicable
It increased my confidence in my ability to make a decision about my situation.	It increased my confidence in my ability to make a decision about my situation. Strongly agree	It increased my confidence in my ability to make a decision about my situation. Agree	It increased my confidence in my ability to make a decision about my situation. Neither agree nor disagree	It increased my confidence in my ability to make a decision about my situation. Disagree	It increased my confidence in my ability to make a decision about my situation. Strongly disagree	It increased my confidence in my ability to make a decision about my situation. Not applicable
It helped me prepare for an appointment or procedure.	It helped me prepare for an appointment or procedure. Strongly agree	It helped me prepare for an appointment or procedure. Agree	It helped me prepare for an appointment or procedure. Neither agree nor disagree	It helped me prepare for an appointment or procedure. Disagree	It helped me prepare for an appointment or procedure. Strongly disagree	It helped me prepare for an appointment or procedure. Not applicable
I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver.	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Strongly agree	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Agree	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Neither agree nor disagree	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Disagree	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Strongly disagree	I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Not applicable
I was satisfied with the tool.	I was satisfied with the tool. Strongly agree	I was satisfied with the tool. Agree	I was satisfied with the tool. Neither agree nor disagree	I was satisfied with the tool. Disagree	I was satisfied with the tool. Strongly disagree	I was satisfied with the tool. Not applicable
I would recommend this tool to others.	I would recommend this tool to others. Strongly agree	I would recommend this tool to others. Agree	I would recommend this tool to others. Neither agree nor disagree	I would recommend this tool to others. Disagree	I would recommend this tool to others. Strongly disagree	I would recommend this tool to others. Not applicable

Strongly agree

Agree

Neither agree nor disagree

Disagree

Strongly disagree

Not applicable

It helped me prepare to have a conversation with my care team.

It helped me prepare to have a conversation with my care team. Strongly agree

It helped me prepare to have a conversation with my care team. Agree

It helped me prepare to have a conversation with my care team. Neither agree nor disagree

It helped me prepare to have a conversation with my care team. Disagree

It helped me prepare to have a conversation with my care team. Strongly disagree

It helped me prepare to have a conversation with my care team. Not applicable

It increased my confidence in my knowledge about my situation.

It increased my confidence in my knowledge about my situation. Strongly agree

It increased my confidence in my knowledge about my situation. Agree

It increased my confidence in my knowledge about my situation. Neither agree nor disagree

It increased my confidence in my knowledge about my situation. Disagree

It increased my confidence in my knowledge about my situation. Strongly disagree

It increased my confidence in my knowledge about my situation. Not applicable

It increased my confidence in my ability to make a decision about my situation.

It increased my confidence in my ability to make a decision about my situation. Strongly agree

It increased my confidence in my ability to make a decision about my situation. Agree

It increased my confidence in my ability to make a decision about my situation. Neither agree nor disagree

It increased my confidence in my ability to make a decision about my situation. Disagree

It increased my confidence in my ability to make a decision about my situation. Strongly disagree

It increased my confidence in my ability to make a decision about my situation. Not applicable

It helped me prepare for an appointment or procedure.

It helped me prepare for an appointment or procedure. Strongly agree

It helped me prepare for an appointment or procedure. Agree

It helped me prepare for an appointment or procedure. Neither agree nor disagree

It helped me prepare for an appointment or procedure. Disagree

It helped me prepare for an appointment or procedure. Strongly disagree

It helped me prepare for an appointment or procedure. Not applicable

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver.

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Strongly agree

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Agree

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Neither agree nor disagree

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Disagree

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Strongly disagree

I shared the resource with a patient, relative, friend, peer, healthcare professional or caregiver. Not applicable

I was satisfied with the tool.

I was satisfied with the tool. Strongly agree

I was satisfied with the tool. Agree

I was satisfied with the tool. Neither agree nor disagree

I was satisfied with the tool. Disagree

I was satisfied with the tool. Strongly disagree

I was satisfied with the tool. Not applicable

I would recommend this tool to others.

I would recommend this tool to others. Strongly agree

I would recommend this tool to others. Agree

I would recommend this tool to others. Neither agree nor disagree

I would recommend this tool to others. Disagree

I would recommend this tool to others. Strongly disagree

I would recommend this tool to others. Not applicable

Checklist and Tip Sheet Wizard feedback form

Thank you for providing feedback on our program

Question Title

1. Which checklist or tip sheet did you download? (Select all that apply).

Question Title

2. How did you learn about our tip sheets and checklists?

Question Title

3. Which of the following describes your interest in this resource? Please select all that apply.

Question Title

4. Please indicate how much you agree with the following statements about the resource.

Question Title

5. Please provide any additional details that you wish about how you used the tool.

Question Title

6. How can we improve this resource? Please comment below.

Question Title

* 1. Which checklist or tip sheet did you download? (Select all that apply).

Question Title

* 2. How did you learn about our tip sheets and checklists?

Question Title

* 3. Which of the following describes your interest in this resource? Please select all that apply.

Question Title

* 4. Please indicate how much you agree with the following statements about the resource.

Question Title

* 5. Please provide any additional details that you wish about how you used the tool.

Question Title

* 6. How can we improve this resource? Please comment below.

1. Which checklist or tip sheet did you download? (Select all that apply).

2. How did you learn about our tip sheets and checklists?

3. Which of the following describes your interest in this resource? Please select all that apply.

4. Please indicate how much you agree with the following statements about the resource.

5. Please provide any additional details that you wish about how you used the tool.

6. How can we improve this resource? Please comment below.