Your comments are important to us. Your feedback is used to help design future educational programs. Please take the time to complete this evaluation. Thank you.

1. Are you a cancer survivor (a survivor is anyone diagnosed with cancer)? Yes       No  If you are not a cancer survivor, what is your relationship? Parent  Spouse  Sibling  Other relative  Caregiver  Friend  Professional Other:  If you are a professional, please indicate your degree and place of work:  Degree (eg, RN, MD, MSW, etc.):    Place of work (eg, hospital, community clinic, private practice, etc.):     2. What is your age? Under 18    18-25    26-30    31-40    41-50    51-60    61-70    71 or older   3. What is your gender? Male         Female   4. If you are a cancer survivor, how long has it been since you were diagnosed?    years    months   5. What was the diagnosis? Acute Lymphocytic Leukemia Acute Myelogenous Leukemia Chronic Lymphocytic Leukemia Chronic Myelogenous Leukemia Hodgkin Lymphoma Myelodysplastic Syndromes Myeloma Non-Hodgkin Lymphoma Other Blood Cancer: Other Cancer:   6. What treatments have been used? Chemotherapy    Radiation    Stem Cell Transplant    Surgery Other:   7. How effective was this program in providing you with information about the following: (Select one answer for each.) Topic Not Effective Somewhat Effective Effective Very Effective The financial impact a cancer diagnosis can have on patients and their families The various insurance programs available to patients Medicare rights and benefits Resources available to assist patients as they navigate through their cancer journey Information sources on financial health matters related to a cancer diagnosis     8. Please give us your feedback on the presentation.  Poor      Fair       Satisfactory      Excellent        9. Overall, how helpful was this program? Not helpful at all       Somewhat helpful       Helpful       Very helpful   10. What could we do to improve this program?   Other comments: Thank you for your comments.