Step 2: Complete the Pre-Activity Survey

Complete the Pre-Activity Survey

PRE

Please answer the following questions:

	Strongly Disagree	Disagree	Agree	Strongly Agree
I know how to manage side effects of treatment for children and adolescents during treatment	I know how to manage side effects of treatment for children and adolescents during treatment Strongly Disagree	I know how to manage side effects of treatment for children and adolescents during treatment Disagree	I know how to manage side effects of treatment for children and adolescents during treatment Agree	I know how to manage side effects of treatment for children and adolescents during treatment Strongly Agree
I know how to manage side effects of treatment once treatment ends	I know how to manage side effects of treatment once treatment ends Strongly Disagree	I know how to manage side effects of treatment once treatment ends Disagree	I know how to manage side effects of treatment once treatment ends Agree	I know how to manage side effects of treatment once treatment ends Strongly Agree
I know how to monitor for long term and late effects from therapy	I know how to monitor for long term and late effects from therapy Strongly Disagree	I know how to monitor for long term and late effects from therapy Disagree	I know how to monitor for long term and late effects from therapy Agree	I know how to monitor for long term and late effects from therapy Strongly Agree
I know what questions to ask my child’s treatment team	I know what questions to ask my child’s treatment team Strongly Disagree	I know what questions to ask my child’s treatment team Disagree	I know what questions to ask my child’s treatment team Agree	I know what questions to ask my child’s treatment team Strongly Agree

Are you a healthcare professional

Yes
No

Phone