Understanding Innovative Myeloma Therapies

1. The program helped you gain a stronger understanding of newer myeloma therapies. *This question is required.

Strongly agree	Agree	Neutral	Disagree	Strongly disagree
Strongly agree	Agree	Neutral	Disagree	Strongly disagree

2. How prepared would you feel to have a conversation regarding CAR T-cell therapy with your healthcare team?  *This question is required.

Very prepared	Prepared	Neutral	Unprepared	Very unprepared
Very prepared	Prepared	Neutral	Unprepared	Very unprepared

3. What else would you like to learn about CAR T-cell therapy? (Check all that apply)
 

• Access and cost
• Eligibility criteria
• Side effects
• Treatment process
• Other - Write In Please enter an 'other' value for this selection.

4. What statement best describes you? *This question is required.

• Patient
• Caregiver
• Healthcare Professional
• Other - Write In Please enter an 'other' value for this selection.

5. What social determinant(s) of health have you or do you currently experience? (Social determinants of health are non-medical factors that influence health outcomes)? (Select all that apply) 

• Living in a rural area
• Lack of housing
• Lack of transportation
• Racism and discrimination
• Barriers with language and literacy skills
• Barriers to accessing nutritious foods
• Barriers to physical activity
• Low socioeconomic status
• Other - Write In Please enter an 'other' value for this selection.
• Not applicable

6. What is your age?  *This question is required.

• Under 18
• 18 - 24
• 25 - 34
• 35 - 44
• 45 - 54
• 55 - 64
• 65 - 74
• 75 - 84
• 85 or older
• Prefer not to say

7. What is your gender identity? *This question is required.

• Female / Woman
• Male / Man
• Transgender
• Nonbinary
• Prefer not to say
• Other - Write In Please enter an 'other' value for this selection.

8. How would you best describe yourself? *This question is required.

• White or Caucasian
• Hispanic, Latino or Spanish origin
• Black or African American
• Asian
• American Indian or Alaska Native
• Native Hawaiian or Pacific Islander
• Prefer not to say
• Other - Write In Please enter an 'other' value for this selection.