Followup Survey

NOTE: All questions are required.

Name of your Mentor Angel

	1 - strongly disagree	2 - disagree	3 - neither agree nor disagree	4 - agree	5 - strongly agree
I am satisfied with the frequency of communication with my Mentor Angel
Based on my relationship with my Mentor Angel, I feel comfortable reaching out to them again in the near future
My Mentor Angel responded to me in a prompt and timely manner
After speaking with my Mentor Angel, I feel more knowledgeable/prepared to continue my experience with cancer
Overall, I am very satisfied with my Mentor Angel

Have you successfully connected with the person you were matched with

YesNo

If you did, how many times did you communicate with them over the last 6 weeks?

Contact Name

	1 - strongly disagree	2 - disagree	3 - neither agree nor disagree	4 - agree	5 - strongly agree
I am satisfied with the frequency and the extent to which I communicated with the person I provided support to
The training I received from Imerman Angels properly set my expectations and prepared me to best help the person I provided support to
I feel I was able to adequately support and positively impact the person I provided support to
My experience with cancer is similar to the person I provided support to
My experience with the Imerman Angels staff members was to my satisfaction

Have you successfully connected with the person you were matched with

YesNo

If you did, how many times did you communicate with them over the last 6 weeks?

What (if any) kind of major life and/or health changes have you experienced since beginning your relationship with Imerman Angels?

Hidden fields

Type	Case ID	Connection 1 ID
Contact ID

Looking back on the past week, including today, how often have you felt each of the following?

Please rate to the extent that you agree with the following statements:

	1 - strongly disagree	2 - disagree	3 - neither disagree nor agree	4 - agree	5 - strongly agree
I have someone who is willing to listen to my concerns relating to my loved one's cancer
I have someone who is willing to listen to my concerns relating to my cancer
I am willing to listen to someone's concerns relating to their cancer
I have the desire/willingness to go through with my treatment(s) and/or procedure(s)
I get emotional support from someone who understands what I am going through
I give emotional support to people touched by cancer
I have the desire/willingness to inspire/support others touched by cancer
I have the desire/willingness to continue to act as a caregiver for my loved one
I believe that my loved one's experience with cancer has given me a greater sense of meaning and purpose
I believe that my experience with cancer has given me a greater sense of meaning and purpose
As a result of my loved one's cancer experience, I have found new and more worthwhile goals
As a result of my experience with cancer, I have found new and more worthwhile goals
I want to continue to share my loved one's experience of cancer
I want to continue to share my experience with cancer
Based on my experience with Imerman Angels, I would recommend the service to someone else touched by cancer

Do you have a desire to become a Mentor Angel now or in the future?

YesNo

Please use the following space to tell us how we can better meet your needs or to provide a general comment.