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Learning Circle Interest with PathWay to Survivorship 

We’re delighted that you expressed interest in joining a virtual Anticancer Lifestyle Program Learning Circle! Learning Circles are designed to help you create a healthy lifestyle with the support, ideas, and encouragement of your peers.

As a next step, please be sure to fill out the participant interest survey below.

Note: All sessions are held via Zoom. Participants are asked to join via laptop placed on a stable surface with a high-speed internet connection, situated in a relatively uninterrupted space. Well-functioning speakers and microphones are required. (Please, no tablets or phones.)

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Full Name
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Address, City & State
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Phone Number 
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Are you still interested and available in joining a virtual Learning Circle January, 2025?
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Yes
No (feel free to close this survey if so)
Maybe later, keep me on the list
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Why are you interested in joining a Learning Circle?
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Have you ever been diagnosed with cancer?
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Yes
No
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If you answered yes, what type of cancer were you diagnosed with? If no, then share your health issues here.
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If you answered yes, when were you first diagnosed with cancer?
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Less than 6 months ago
6 months to a year ago
More than a year ago
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What is your age range?
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18-24
25-34
35-44
45-54
55-64
65+
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Gender: How do you identify?
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Man
Woman
Prefer not to say
其他…
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Are you available and committed to the date and time frame below? 

Introduction to ACLP Learning Circle
Friday, January 3, 2025  at 7:00 pm est.

Learning Circle Sessions
Saturday, January 18, 2025 at 11:00 am - 1:00 pm est.
Saturday, February 15, 2025 at 11:00 am - 12:30 pm est.
Saturday, March 15, 2025 at 11:00 am - 12:30 pm est.
Saturday, April 19, 2025 at 11:00 am - 12:30 pm est.
Saturday, May 17, 2025 at 11:00 am - 12:15 pm est. 
Saturday, June 21, 2025 at 11:00 am - 12:15 pm est. 
Saturday, July 19, 2025 at 11:00 am - 12:15 pm est. 
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YES
No
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Do you have any questions or concerns about joining a Learning Circle?
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Full Name
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目前還沒有人回應這條問題。
Address, City & State
目前還沒有人回應這條問題。
Phone Number 
複製圖表
目前還沒有人回應這條問題。
Are you still interested and available in joining a virtual Learning Circle January, 2025?
複製圖表
目前還沒有人回應這條問題。
Why are you interested in joining a Learning Circle?
目前還沒有人回應這條問題。
Have you ever been diagnosed with cancer?
複製圖表
目前還沒有人回應這條問題。
If you answered yes, what type of cancer were you diagnosed with? If no, then share your health issues here.
複製圖表
目前還沒有人回應這條問題。
If you answered yes, when were you first diagnosed with cancer?
複製圖表
目前還沒有人回應這條問題。
What is your age range?
複製圖表
目前還沒有人回應這條問題。
Gender: How do you identify?
複製圖表
目前還沒有人回應這條問題。
Are you available and committed to the date and time frame below? 

Introduction to ACLP Learning Circle
Friday, January 3, 2025  at 7:00 pm est.

Learning Circle Sessions
Saturday, January 18, 2025 at 11:00 am - 1:00 pm est.
Saturday, February 15, 2025 at 11:00 am - 12:30 pm est.
Saturday, March 15, 2025 at 11:00 am - 12:30 pm est.
Saturday, April 19, 2025 at 11:00 am - 12:30 pm est.
Saturday, May 17, 2025 at 11:00 am - 12:15 pm est. 
Saturday, June 21, 2025 at 11:00 am - 12:15 pm est. 
Saturday, July 19, 2025 at 11:00 am - 12:15 pm est. 
複製圖表
目前還沒有人回應這條問題。
Do you have any questions or concerns about joining a Learning Circle?
目前還沒有人回應這條問題。
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