We are dedicated to empowering you and supporting your journey toward healing, improved health and NOT letting cancer take more of you than it already has.

Your insights are invaluable, and your responses will help us tailor our resources and programs to support your goals. Thank you for being here and sharing a bit about yourself with us.

With gratitude and excitement,

After the Bell Cancer Academy Co-Founders
Alison Doty
Staci Smith

Please provide your name and address to receive your free gift. Your email is your login to free classes and a link will be sent to you. Kindly indicate your gender, as this survey is for women’s research purposes. However, we welcome all genders.

First Name *

Last Name *

Email *

Gender

Address

Street Address *

City *

State *

Postal Code *

Country

Are you currently cancer free? *

Yes

No

If you are currently cancer free, how many years? *

Have you had a reoccurance since your first diagnosis? *

Yes

No

How long were you cancer free before reoccurance? *

What age were you when your cancer treatments were complete? *

Do you have side effects from any after treatment medication such as a hormone blocking medication? With 1 being "not at all" and 5 being "severe side effects". *

Did/do you attend any support groups? *

1. No, I had/have a great support system.

2. No, it was/is not convenient.

3. No, it was/is too far away.

4. Yes, it worked when I needed it.

5. Yes, and still going.

Has the cancer diagnosis changed your lifestyle? With 1 being "Nope, it's still the same" and 5 being "Yes, this has been completely life altering." *

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