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CANCER IMPACT SURVEY

Share your story

At iHeal, we are working hard to develop resources that will bring comfort, hope and clarity for those going through this difficult journey.
You can help by letting us know how you have been impacted by cancer.
Help us remove confusion from cancer by filling out our brief survey below.

Cancer Impact Survey

* Indicates required field

1. In the last 10 years, have any of your close friends or family members been diagnosed with cancer? *

No Yes - Immediate family member(s) Yes - Extended family member(s) Yes - Close friend(s)

If yes, which form(s) of cancer? *

2. During the course of your life, how many loved ones have you lost to cancer? *

0 1-3 4-6 7-9 10 +

3. According to you, what is the hardest thing a person has to deal with when going through the cancer journey? *

Emotional distress - lack of hope, helplessness, anxiety, depression Physical suffering Perceived social stigma - shame Other

If other, please explain. *

4. In your opinion, what is the #1 cause for most cancers? *

Heredity (our genes) Environmental (pollution, toxins, etc.) Lifestyle (how we eat, work, live, etc.) Other

If other, please elaborate. *

5. According to you, when a loved one gets cancer, what are the top three things a close friend, or family member, can do to show care and support? *

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iHeal is a division of Lifestyle Canada Education Service
Canadian Charity Registration # 82964 7486 RR0001

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