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First Connection Feedback Form

We hope your experience with our First Connection program was positive.  In order to continually improve the program and assist future patients and caregivers, we need your feedback and suggestions.

Please take a moment to complete the following evaluation form.  All responses will remain private and confidential.

*required fields    

Your Name
Your First Connection Counselor's Name
Was the connection helpful?*YesNo
Would you recommend this service to others?*YesNo
Did you receive the information that you needed?*YesNo
The best thing about this program for me was:
I believe the program would be more helpful if:
I believe my personal experience with the program would have been more helpful if:






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last updated on 04/12/07
The Leukemia & Lymphoma Society® (LLS) is the world's largest voluntary health agency dedicated to blood cancer. The LLS mission: Cure leukemia, lymphoma, Hodgkin's disease and myeloma, and improve the quality of life of patients and their families. LLS funds lifesaving blood cancer research around the world and provides free information and support services.
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