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:
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Person with colon
cancer |
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Family member |
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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)?
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
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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
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