Please complete the following survey if you are using or have used any complementary therapy. Send the completed survey to: info@vhl.org. Feel free to use additional space and write as much as you like. Your name and address are optional.

Under the EDIT menu of your browser, choose SELECT ALL.
Press Control+C (or on Macintosh, Command+C) to copy this page. Then click on Altheada's address above. Paste this text into the message body, and edit your answers in among the questions.

1. Which complementary therapies or treatments are you or have you used in the past? These might include foods, teas, non-traditional drugs, yoga, and/or meditation.

2. If you are using a complementary therapy, have you informed your primary care physician or general practitioner? Yes/No. If no, why not?

3. Did your primary care physician or general practitioner ever give you any information or suggestions about complementary or alternative cancer treatments? Yes/No. If Yes, which one(s)? Which, if any, do you use?

4. Some people use complementary therapies to maintain wellness or prevent illness. Did you use or are you using any foods, teas, non-traditional drugs, yoga, prayer and/or meditation for any of the following reasons? Check all that apply, and please explain.

___ Stress management

___ General Health and Fitness

___ Prevention

___ None of the above

___ Other

5. How helpful has the use of this complementary therapy been for you?

6. What changes have you noticed in your condition, whether beneficial of not?

7. Would you recommend any of these complementary therapies to someone else? Yes/No.

If Yes, which one(s)?

8. Please make any additional comments. We would appreciate hearing your experiences.

9. Your name and address are optional.

As published in the VHL Family Forum 5:1, March 1997. For permission to reprint, please contact VHL Family Alliance, editor@vhl.org. Further information is available from the VHL Family Alliance, info@vhl.org.