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Understanding Advancements in Treating Myeloma - Virtual Houston Sept 9, 2017

Page One

Thank you for participating in our program. Please take a few moments to complete this questionnaire to help us develop future programs for people living with Multiple Myeloma. Your feedback is invaluable.

1. Please choose the one statement that best describes you. (Choose only one) *This question is required.

Please enter an 'other' value for this selection.

When were you diagnosed? *This question is required.

What best describes your diagnosis?

What treatments are you currently receiving or have received in the past (check all that apply) *

Space Cell	Current	Past
Adriamycin (doxorubicin)	Adriamycin (doxorubicin) : Current	Adriamycin (doxorubicin) : Past
Alkeran (melphalan)	Alkeran (melphalan): Current	Alkeran (melphalan): Past
Aredia (pamidronate)	Aredia (pamidronate): Current	Aredia (pamidronate): Past
BiCNU (carmustine)	BiCNU (carmustine): Current	BiCNU (carmustine): Past
Cytoxan (cyclophosphamide)	Cytoxan (cyclophosphamide): Current	Cytoxan (cyclophosphamide): Past
Darzalex (daratumumab)	Darzalex (daratumumab) : Current	Darzalex (daratumumab) : Past
Decadron (dexamethasone)	Decadron (dexamethasone): Current	Decadron (dexamethasone): Past
Eposin (etoposide)	Eposin (etoposide): Current	Eposin (etoposide): Past
Empliciti (elotuzumab)	Empliciti (elotuzumab) : Current	Empliciti (elotuzumab) : Past
Farydak (panobinostat)	Farydak (panobinostat): Current	Farydak (panobinostat): Past
Kyprolis (carlfilzomib)	Kyprolis (carlfilzomib): Current	Kyprolis (carlfilzomib): Past
Ninlaro (ixazomib)	Ninlaro (ixazomib) : Current	Ninlaro (ixazomib) : Past
Oncovin (vincristine)	Oncovin (vincristine): Current	Oncovin (vincristine): Past
Platin (cisplatin)	Platin (cisplatin): Current	Platin (cisplatin): Past
Pomalyst (pomalidomide)	Pomalyst (pomalidomide): Current	Pomalyst (pomalidomide): Past
Revlimid (lenalidomide)	Revlimid (lenalidomide): Current	Revlimid (lenalidomide): Past
Thalomid (thalidomide)	Thalomid (thalidomide): Current	Thalomid (thalidomide): Past
Velcade (bortezomib)	Velcade (bortezomib): Current	Velcade (bortezomib): Past
Xgeva (denosumab)	Xgeva (denosumab): Current	Xgeva (denosumab): Past
Zometa (zoledronic acid)	Zometa (zoledronic acid): Current	Zometa (zoledronic acid): Past
Other	Other: Current	Other: Past

If you chose "other" above, please specify.

Have you undergone genetic testing? *This question is required.

What lifestyle factors affect your treatment decisions?

Please enter an 'other' value for this selection.

Do you think these types of lifestyle factors are important to consider when choosing a treatment? How might they impact your choice of treatment?

Do you ever bring up these types of considerations when choosing a treatment? Why or why not?

To what extent does your caregiver support (or lack of) factor into your treatment decisions? Why?

Would You Consider Participating in a Clinical Trial?

Are you participating in a clinical trial now or have you in the past?

Do you know what medicine is/was being investigated?

What medicine is/was being investigated?

Would you consider being part of a small group discussion to help guide the development of new medicines?

If you are interested in sharing more about your experience living with Multiple Myeloma, please provide us with your contact information (Email address and/or phone number)

2. How Would You Rate Today's Discussion?

Excellent	Good	Fair	Poor
Excellent	Good	Fair	Poor

3. How much did this program increase your understanding of myeloma? (choose your answer on the scale below - 10 being the highest)

1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)
1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)

4. How well did the program help you understand the current treatments and research?

1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)
1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)

5. How well did this program give you more confidence and help you feel you are in control as you face your disease?

1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)
1 (Not at All)	2	3	4	5	6	7	8	9	10 (A Great Deal)

6. How would you rate our participants?

Space Cell	Excellent	Good	Fair	Poor
Dr. Gareth Morgan *This question is required	Dr. Gareth Morgan: Excellent	Dr. Gareth Morgan: Good	Dr. Gareth Morgan: Fair	Dr. Gareth Morgan: Poor
Dr. Faith Davies *This question is required	Dr. Faith Davies: Excellent	Dr. Faith Davies: Good	Dr. Faith Davies: Fair	Dr. Faith Davies: Poor
Dr. Frits van Rhee *This question is required	Dr. Frits van Rhee: Excellent	Dr. Frits van Rhee: Good	Dr. Frits van Rhee: Fair	Dr. Frits van Rhee: Poor
Dr. Guido Tricot *This question is required	Dr. Guido Tricot: Excellent	Dr. Guido Tricot: Good	Dr. Guido Tricot: Fair	Dr. Guido Tricot: Poor
Dr. Brian Walker	Dr. Brian Walker: Excellent	Dr. Brian Walker: Good	Dr. Brian Walker: Fair	Dr. Brian Walker: Poor
Kristen Carter, APRN	Kristen Carter, APRN: Excellent	Kristen Carter, APRN: Good	Kristen Carter, APRN: Fair	Kristen Carter, APRN: Poor
Alan Stephenson	Alan Stephenson: Excellent	Alan Stephenson: Good	Alan Stephenson: Fair	Alan Stephenson: Poor
Jeff Folloder, Host *This question is required	Jeff Folloder, Host: Excellent	Jeff Folloder, Host: Good	Jeff Folloder, Host: Fair	Jeff Folloder, Host: Poor

7. How would you rate each session?

Space Cell	Excellent	Good	Fair	Poor
Meet & Greet: Getting To Know Others With Myeloma	Meet & Greet: Getting To Know Others With Myeloma : Excellent	Meet & Greet: Getting To Know Others With Myeloma : Good	Meet & Greet: Getting To Know Others With Myeloma : Fair	Meet & Greet: Getting To Know Others With Myeloma : Poor
Understanding Myeloma and Current Treatments	Understanding Myeloma and Current Treatments : Excellent	Understanding Myeloma and Current Treatments : Good	Understanding Myeloma and Current Treatments : Fair	Understanding Myeloma and Current Treatments : Poor
Updates in Research and How To Get Involved	Updates in Research and How To Get Involved: Excellent	Updates in Research and How To Get Involved: Good	Updates in Research and How To Get Involved: Fair	Updates in Research and How To Get Involved: Poor
The Importance of Genetic Testing & Imaging	The Importance of Genetic Testing & Imaging : Excellent	The Importance of Genetic Testing & Imaging : Good	The Importance of Genetic Testing & Imaging : Fair	The Importance of Genetic Testing & Imaging : Poor
Meet the Patient Panel	Meet the Patient Panel : Excellent	Meet the Patient Panel : Good	Meet the Patient Panel : Fair	Meet the Patient Panel : Poor
Living Life to the Fullest With Myeloma	Living Life to the Fullest With Myeloma : Excellent	Living Life to the Fullest With Myeloma : Good	Living Life to the Fullest With Myeloma : Fair	Living Life to the Fullest With Myeloma : Poor
Q&A - General Session	Q&A - General Session: Excellent	Q&A - General Session: Good	Q&A - General Session: Fair	Q&A - General Session: Poor

8. Program Content – please provide suggestions of topics you would like us to cover in the future.

9. Meet & Greet – Did you find this session useful? If so, why?

10. Additional comments

11. Which of the following actions will you take as a result of this program? (Check all that apply)

I will speak to my doctor about treatments discussed
I will inquire about genetic testing
I will continue my current treatment plan, confident that it is right for me
I will inquire about participating in a clinical trial
I will speak to my doctor about whether there are specific activities that might be right for me to improve my quality of life
I will visit www.myeloma.uams.edu for more content about myeloma
I will visit www.patientpower.info for more content about myeloma
I will recommend the websites and content from this program to others
Other

12. If we produced another program like this next year as there are new developments, would you plan to attend online?

13. What is your gender?

14. What is your age?

15. Where do you live?

Please enter an 'other' value for this selection.
Please enter an 'other' value for this selection.