How did you access the Breast Cancer Answers web site?

How did you learn about the Breast Cancer Answers web site?

On a scale of 1-10, where 1 is not at all effective, and 10 is very effective, please rate the overall effectiveness of the following areas of the Breast Cancer Answers web site:

California Clinical Trials Matching System		1 (not at all) 2 3 4 5 6 7 8 9 10 (very)
Personal Stories		1 (not at all) 2 3 4 5 6 7 8 9 10 (very)
Art Gallery		1 (not at all) 2 3 4 5 6 7 8 9 10 (very)

On a scale of 1-10, where 1 is not at all likely, and 10 is very likely, how likely is it that you will refer other women to the Breast Cancer Answers web site?

Do you have any comments or suggestions on how we can improve the Breast Cancer Answers web site?

Demographics/Health Behavior

Please check any of the following items that best describe(s) you: (Check all that apply).

breast cancer patient or survivor family member or friend of a breast cancer patient health care provider researcher other (please specifiy )

Have you ever brought up the topic of breast cancer clinical trials with a health care professional?

Don't know Yes No

Has a health care professional ever brought up the topic of breast cancer clinical trials with you?

Don't know Yes No

What is your sex? Female Male

What is your age?

Where do you live?

City State Country

Which of the following best describe(s) you? (Check all that apply)

African-American, Black Aleutian, Eskimo American Indian Asian or Pacific Islander White, Caucasian Hispanic Other (please specify ) Don't know

What is the highest grade or year of school you completed?

Grade 1 through 8 Grade 9 through 11 Grade 12 or GED Junior college or vocational school College 1 year to 3 years, or no degree College 4 years or more, or received degree Graduate or professional school Don't know

Follow-Up Survey

In order to evaluate the Breast Cancer Answers web site over time, we would like to send you a follow-up survey in a few months. If you would be willing to complete another survey for us, please enter your name and address below.

Name
Address
City
State
ZIP Code
e-mail address

Thank you for helping us evaluate our website!