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* 1. Which of the following best describes you:

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* 2. Please select your province/territory

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* 3. Please indicate the first three characters of your postal code

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* 4. Please indicate your level of agreement with the following statement

  Strongly Disagree Disagree Neutral Agree Strongly agree
I feel connected to others who understand my experience.
I feel isolated in managing this condition.
I have someone I can speak to who truly understands what I’m going through.
I feel comfortable asking questions about living with this condition.
I feel confident managing day-to-day challenges related to this condition.
I feel confident navigating the healthcare system.
I understand my treatment and care options.
I feel prepared to make decisions about my care (or my child’s care).
I feel hopeful about my ability to live well with this condition.

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* 5. What types of information would be most helpful to you? Select all that apply

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* 6. I feel I have enough practical information about living with this condition.

1 5
Clear
i We adjusted the number you entered based on the slider’s scale.

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* 7. Which formats interest you for peer support? Select all that apply

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* 8. If participating in 1:1 mentorship, what would be most important to you?

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* 9. What is the biggest challenge you are currently facing?

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* 10. What would “good peer support” look like to you?

T