Cancer Buddy System - User Survey

To help us improve on the Cancer Buddy System, please complete this survey. All information is CONFIDENTIAL.Thank you for your time!

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* 1. Please provide a mailing address or email if you would like to receive a gift card upon completion of this survey courtesy of the Asian American Cancer Support Network. You can by pass this question if you are not interested in a gift card.

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* 2. Are you:

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* 3. Would you prefer to be paired with someone close to your age group?

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* 4. Would you prefer to be paired with someone close to your age group?

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* 5. What is your ethnic background?

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* 6. What is your preferred language

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* 7. What type of cancer do you have or did you have?

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* 8. Are you a cancer survivor interested in being a cancer buddy?

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* 9. Have you been newly diagnosed with cancer?

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* 10. Are you a caregiver for someone with cancer?

Thank you for taking time to complete this survey. We appreciate your feedback!
If you would like to contact us, feel free to email info@aacsn.org or visit us on www.facebook.com/aaccsn or www.cancerbuddysystem.org to become a buddy today!

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