1. What is your zip code?    
   
   
2. Complete the sentence - "I am looking for cancer information today because I am
   a cancer patient."
   a cancer survivor."
   a family member or other caregiver for a cancer patient."
   a health professional (physician, nurse, physician assistant)."
   a social worker, patient advocate/navigator or case manager."
   a community cancer control worker or health policy planner."
   a researcher."
   an education professional."
   a student."
   an interested member of the general public."
   none of the above. I am a/an ."
   
   
3. What information are you looking for? Check all that apply.
   Physicians who provide diagnosis, treatment or continuing care for cancer patients
   Health facilities (hospitals, treatment centers, home health agencies, etc.)
   Screening or treatment for low-income or uninsured patients
   Cancer screening services (mammography, colorectal cancer screening, etc.)
   Support services (support groups, financial assistance, transportation, etc.)
   Survivorship resources
   Cancer prevention and early detection information
   Cancer treatment information
   Statistics (cancer rates, population, insurance coverage, poverty levels, etc.)
   Community cancer control (local coalitions, tools, events, etc.)
   Grant funding information for cancer research or community cancer control
   Other information (please specify):
   
   
4. How often do you visit the TCI Web site?
   Often
   Sometimes
   This is my first time.
   
   
5. Is there any other information you would like to see included on the TCI Web site? Please list, below.