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Join the fight against cancer today!!!
Partnering with us to help and assist people diagnosed with cancer and their families. Cancer doesn’t stop. So neither will we.
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Age
*
Gender
*
Male
Female
Multiple Choice
First Choice
Second Choice
Third Choice
Has someone close to you been diagnosed with cancer?
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Yes
No
If yes, what type of cancer?
*
Breast Cancer
Cervical Cancer
Prostate Cancer
Other (Specify below)
Specify
Has the experience of dealing with cancer in your family influenced your views on cancer prevention, screening, or treatment?
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Yes
No
How did you hear about the #WalkAwayCancer campaign?
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Social Media
TV/Radio
Friends/Family
Others (Specify Below)
Specify
If How on
Have you participated in the #WalkAwayCancer campaign before?
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Yes
No
If yes, how many times have you participated?
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1
2
3
4
5
6
7
8
9
10
Rate your previous experience at #WalkAwayCancer
*
Excellent
Good
Average
Fair
Poor
Did participating in the walk improve your understanding of cancer prevention and early detection?
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Yes
No
How would you rate the campaign's impact on increasing your cancer awareness?
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Very High
High
Moderate
Low
Very Low
How Confident are you about your knowledge of Breast cancer?
*
Very Confident
Somewhat Confident
Not Confident
How Confident are you about your knowledge of Cervical cancer?
*
Very Confident
Somewhat Confident
Not Confident
What sources do you rely on for cancer information?
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Health Professionals
Internet
Social Media
Friends/Family
Others (Specify Below
Specify:
Has participating in the walk improved your knowledge of where to access cancer screening or treatment services?
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Yes
No
Do you think Walk Away Cancer has contributed to long-term cancer awareness in the community?
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Yes
No
How likely are you to participate in cancer awareness activities in the future?
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Very Likely
Likely
Neutral
Unlikely
Very Unlikely
How conversant are you with Medicaid Cancer Foundation activities (Outreaches, Hospital Visits)?
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Very conversant – I regularly attend and follow their events.
Somewhat conversant – I know about their events but don’t participate often.
Not very conversant – I have heard of their events but rarely follow them
Not conversant at all – This is my first time learning about their events
Not conversant at all – I would love to be carried along
How can we improve on what we do:
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