We would like your help in determining what types of articles or features to include in future issues of the newsletter. Please fill out the questionnaire below and send it to the address given at the end of the page. You do not need to include your name or address to reply to this survey. Thank you for your time. This information will help us to better meet your needs.

Let us know who you are:

Person with colon cancer

Family member

Professional

1. What was most helpful?____________________________________________________________

2. What was not helpful?_____________________________________________________________

3. What topics would you like to see covered in future issues? _______________________________

4. Do you want to continue receiving the newsletter? Yes No

5. What are your other sources of information regarding colon cancer (check all that apply)?

	Doctor/nurse		Family/friends		Internet		Genetic counselor		TV/media
	Library/books		Support groups		No source of information
	Other________________________________________________________________________

6. Have you and your family ever had an opportunity to meet or correspond with other families at risk for hereditary colon cancer? Yes No

Explain:___________________________________________________________________________

7. Do you have questions that you would like to have answered in the next newsletter?

Please include your contact information if you answer questions (8-10).

8. Would you be willing to write about your experiences in a future newsletter issue? Yes No

9. Would you prefer to access the newsletter online and be removed from the mailing list? Yes No

10. Your suggestion for The Name the Newsletter Contest!

__________________________________________________________________________________

NAME:___________________________________________________________________________

PHONE:__________________________________________________________________________

ADDRESS:________________________________________________________________________

MAIL TO:
Wendy Kohlmann, M.S.
Department of Behavioral Science, Box 243
The University of Texas M.D. Anderson Cancer Center
1515 Holcombe Blvd.
Houston, TX 77030