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Cancer Survivorship Research


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OMB NO: 0925-0046

Contact the Staff of the OCS
6116 Executive Boulevard,
Suite 404
Bethesda, MD 20892

Phone Number (301) 402-2964
Fax (301) 594-5070
ncidccpsocsweb-r@mail.nih.gov

Feedback Form

The National Cancer Institute's (NCI) Division of Cancer Control and Population Sciences (DCCPS) is in the process of building the Office of Cancer Survivorship (OCS) web site and would appreciate your feedback to help us make the site more valuable. Your responses are strictly confidential, and you may skip and questions you do not want to answer. Thank you.

1. What exact information were/are you looking for on this site?

2. In looking for cancer survivorship information on the web, what difficulties or frustrations have you encountered?

3. What web sites have you found most useful in searching for surviviorship information? (Please provide name and/or URL if known.)

4. Have you visited the Office of Cancer Survivorship (OCS) Web site before?

5. Please complete the following statement: "Using the Office of Cancer Survivorship Web site, I wish I could..."

About you:
6. About how many hours per week do you use the World Wide Web?

7. Which of the following best describes you?
    Cancer survivor in active treatment
    Cancer survivor post treatment
    Friend/family of cancer survivor
    Oncologist
    Physician (non-oncology)
    Oncology nurse
    Nurse (non-oncology)
    Other Health Professional
    Librarian
    Patient advocate
    Researcher/scientist
           Other: please specify

8. In what year were you born?

9. Do you live in the:
    USA
    Outside USA

Thank you for your time. We appreciate your thoughts and ideas. If you would like to send additional thoughts, please e-mail the Office directly at ncidccpsocsweb-r@mail.nih.gov



Public reporting burden for this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0046). Do not return the completed form to this address.

 

Last Updated: November 6, 2006

 

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