MACGN Newsletter Evaluation
	Print the Evaluation Form(Adobe Acrobat PDF) and mail or fax it back.

Please download and complete this questionnaire (Adobe PDF file). When you are done filling out the survey, you may fax it to (410) 502-7670 or return it by mail to:

Mid-Atlantic Cancer Genetics Network
The Johns Hopkins University
2024 E. Monument Street, Suite 2-607
Baltimore, Maryland, 21205-2223

You may remain anonymous. However, we would like to send you a token of our gratitude. If you fill out your mailing information at the top of this form, we will send you a small "thank you" gift for your effort.

The following is the information we are asking for in the questionnaire.

Mailing Information (optional)

Name___

Mailing Address_____________________________

I.Demographic Questions (Please check)

Age: __18-30 __31-40 __41-50 __51-60 __61-70 __71 and up

Gender __Male __Female

Race/Ethnicity
__African American __Asian American __Hispanic/Latino
__Native American __Caucasian/White
Other _____________________

Highest level of education
__Junior High School __High School or GED
__College or University __Graduate/Professional Degree

Profession _________________________________

II.Content (Please circle your answer.)

1. To what extent do you read the MACGN newsletter?
1. I read all of it(8 pages).
2. I read most of it, but not all (5-7 pages).
3. I read about half of it (3-4 pages)
4. I read some of it(1-2 pages)
5. I don't read the newsletter at all.
2. How helpful do you find the following sections?

   	Not Helpful	Somewhat helpful	Natural	Helpful	Very Helpful
   Feature Articles	1	2	3	3	5
   Health Living Column	1	2	3	3	5
   Review Corner	1	2	3	3	5
   Research Opportunities	1	2	3	3	5
   Local Cancer & Genetics Resources	1	2	3	3	5

3. How would you rate the OVERALL QUALITY of the information in the newsletter?

   Poor	Fair	Neutral	Good	Excellent
   1	2	3	4	5

4. Has any of the information in the newsletter caused you to modify your clinical practice and/or personal health activities?
   __Yes __No

What topics would you like us to cover?
_________________________________________________

How could MACGN make the newsletter more useful to you?
_________________________________________________

Thank you for your help. We are working hard to make the MACGN newsletter as helpful to you as possible, and we appreciate your participation in this effort. Please return this survey by mail or FAX (410) 502-7670.

 

 

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