Post-Video Survey

Please complete this short survey after watching this video series, so that we can understand what you learned.

1. I am viewing this video series as a: *

2. My age is: *

2B. The age of the patient is: *

3. Have you or the patient been diagnosed with a blood cancer? *

Yes

No

The patient’s diagnosis (select all that apply): *

4. When was the patient first diagnosed with a blood cancer?

Month: *

Year: *

5. The patient’s treatment status: *

Watch and wait (active surveillance)	Exploring treatment options
Receiving treatment or maintenance	Treatment completed
Other (specify): Other (specify):

6. My gender is: *

Female

Male

Prefer to self-describe

7. My race is (select all that apply): *

8. Do you consider yourself Hispanic/Latino? *

Yes

No

Prefer not to disclose

9. How did you hear about this video series? (check all that apply): *

10. Has the doctor or another healthcare professional ever spoken to you about Minimal Residual Disease (MRD)? *

Yes

No

Do not recall or unsure

11. Has the patient or caregiver ever spoken to a doctor or other professional about how MRD is utilized for your blood cancer? *

Yes

No

Do not recall or unsure

Who brought up the topic of MRD? *

The patient/caregiver brought up the topic

A doctor or other professional brought up the topic

Do not recall or unsure

Has the results of MRD testing influenced the treatment protocol for the patient? *

Yes

No

Unsure

12. Please choose true or false: *

	True	False
MRD stands for Minimal or Measurable Residual Disease	True	False
MRD is utilized to tailor therapy for many blood cancer patients.	True	False
MRD positivity is when there are no detectable cancer cells found when tested for MRD.	True	False

13. How confident are you that you can do the following for a doctor’s appointment: *

	Not at all confident	Not very confident	Somewhat confident	Mostly confident	Totally confident
Prepare and think about what you want to ask your doctor/treatment team about how MRD may be utilized for your diagnosis	Not at all confident	Not very confident	Somewhat confident	Mostly confident	Totally confident

14. Using a scale from 1-7 (with 1 = "Not at all important" and 7 = "Very important"), *

	1	2	3	4	5	6	7
How important do you feel it is to talk to your doctor about MRD?	1	2	3	4	5	6	7

15. Using a scale from 1-7 (with 1 = "Not at all likely" and 7 = "Will definitely dictate my treatment plan"), *

	1	2	3	4	5	6	7
How important is MRD in determining your treatment plan?	1	2	3	4	5	6	7

16. Please provide us any additional questions/ comments/ or experiences regarding MRD in the box below:

First Name *

Last Name *

Email Address *

Patient/survivor	Caregiver
Friend/family member	Healthcare professional
Other (please specify): Other (please specify):

Acute lymphoblastic leukemia (ALL)	Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)	Chronic lymphocytic leukemia (CLL)
Hodgkin lymphoma	Non-Hodgkin lymphoma
Myelodysplastic syndrome (MDS)	Myeloma
Myeloproliferative neoplasm (MPN)	Another blood cancer (specify): Another blood cancer (specify):

American Indian or Alaska Native	Asian
Black or African American	Native Hawaiian or Pacific Islander
White or Caucasian	Prefer not to disclose
Other (please specify): Other (please specify):

Email invitation	Internet/LLS website
LLS staff or volunteer	A healthcare provider
A friend/family member	Social media
Other (please specify): Other (please specify):