Survey - Report Back - Changing the Conversation with your community

Did you share information in your community about Breast Cancer Deadline 2020® ?

1.

Contact Information

*

Name:

First Required	Last Required

*

Email: Required

Remember me. What's this?

*2.

Question - Required - With whom did you have a conversation? (choose all that apply.)
Please make between 1 and 5 selections from the choices below.

*3.

Question - Required - Did you use the Advocate Toolkit Resources

4.

Question - Not Required - What other resources would be helpful?

5.

Question - Not Required - Other

6.

Question - Not Required - What other personal actions do you plan to take in the next 3 months that will help achieve Breast Cancer Deadline 2020®?

	Talk to my local groups planning October Breast Cancer Awareness Month activities about Breast Cancer Deadline 2020®.
	Encourage other groups to endorse Breast Cancer Deadline 2020® on NBCC's website.
	Plan a fundraising event to support NBCC's Breast Cancer Deadline 2020®.
	Get ON THE CLOCK again or for the first time.
	Talk to local media about Breast Cancer Deadline 2020®.
	Talk to my physician or local researcher about Breast Cancer Deadline 2020®.

*7.

Question - Required - Other:

* indicates required response.