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Expanding Treatment Options for CLL | September 23, 2017

Page One

Thank you for participating in our program.  Please take a few moments to complete this questionnaire to help us develop future programs for people living with Chronic Lymphocytic Leukemia (“CLL”).
1. Please choose the one statement that best describes you.  (Choose only one): *This question is required.
When were you diagnosed? *This question is required.
What treatments are you currently receiving or have received in the past (check all that apply) 
Space Cell CurrentPast
Adriamycin (doxorubicin)
Arzerra (ofatumumab)
Campath (alemtuzumab)
Cytoxan (cyclophosphamide)
Fludara (fludarabine)
Gazyva (obinutuzumab)
Imbruvica (ibrutinib)
Leukeran (chlorambucil)
Leustatin (cladribine)
Nipent (pentostatin)
Oncovin (vincristine)
Revlimid (lenalidomide)
Rituxan (rituximab)
Treanda (bendamustine)
Stem cell transplantation
Venclexta (venetoclax)
Other (please specify below)
Are you participating in a clinical trial now or have you in the past?
Would you consider participating in a clinical trial?
Would you consider being part of a small group discussion to help guide the development of new medicines?
2. How would you rate today’s discussion?

How knowledgeable do you consider yourself in understanding CLL (choose your answer on the scale below - 10 being the highest)?

*This question is required.
1 (Not knowledgable at all)2345678910 (Very knowledgable)
4. How much did this program increase your understanding of CLL? 
1 (Not at All)2345678910 (A Great Deal)
5. How well did the program help you understand the current treatments and research? *This question is required.
1 (Not at All)2345678910 (A Great Deal)
6. How well did this program give you more confidence and help you feel in control as you face your disease?
1 (Not at All)2345678910 (A Great Deal)
7. How would you rate our participants?
Space Cell ExcellentGoodFairPoorN/A
Michael Keating, MB, BS
Jeff Sharman, MD
Kathryn Kolibaba, MD
Stephen E. Spurgeon, MD
Nora Larson, MSW, CSWA, LICSWA
Christine, Patient Advocate
Ralph, Patient Advocate
Andrew Schorr, Host
8. How would you rate the sessions?
Space Cell ExcellentGoodFairPoorN/A
Meet Other Patients and Care Partners
Understanding CLL and Current Treatment Options
Developing CLL Research: What Could It Mean for You
Monitoring Your CLL and Choosing a Treatment Path
Meet the Patient Panel: Inspiring Stories and Advice
Tools for Living Well With CLL
What suggestions can you provide to help us improve our program?
12. Which of the following actions will you take as a result of this program? (Check all that apply)
13. If we produced a similar program via live stream on the Internet, would you be interested in attending online again?
14. What is your gender?
15. What is your age?
16. Where do you live?