High Risk Survey Web Screenshot

SEX

FATHERCANCER

FATHERCANCERTYPE1-4

MOTHERCANCER

MOTHERCANCERTYPE1-4

NUMBROTHERS

BROTHERCANCER

BROTHERCANCERTYPE1-4

NUMBROTHERCANCER1-4

NUMSISTERS

SISTERCANCER

SISTERCANCERTYPE1-4

NUMSISTERCANCER1-4

NUMBERSONS

SONCANCER

SONCANCERTYPE1-4

NUMSONCANCER1-4

NUMBERDAUGHTERS

DAUGHTERCANCER

DAUGHTERCANCERTYPE1-4

NUMDAUGHTERCANCER1-4

NUMSECONDCANCER

SECBREASTCAN

SECOVARIANCAN

CANCERWORRY

WORRYCANCSPECIFIC/ WORRYBACKOFMIND/ WORRYCHANCECANCER

PERCEIVEDCOLONCANCERRISK

PERCEIVEDBREASTCANCERRISK

PERCEIVEDOVARCANCERRISK

PRIMARYPLACEFORHEALTHADVICE

DOCTORRISK

DOCTORRISK2

COMSATISFIED

DOCEASYTOUNDERSTAND

DOCLISTEN

COUNSELING

COUNSELINGREASON

COUNSATISFIED

BRCATEST

TESTRESULTBR

LYNCHTEST

TESTRESULTLYNCH

SHARERESULTSMOTHER/SHARERESULTSFATHER/SHARERESULTSPARTNER/SHARERESULTSSISTER/SHARE
RESULTSBROTHER

SHARERESULTSDAUGHTER/SHARERESULTSSON/SHARERESULTSAUNTUNCLE/SHARERESULTSCOUSIN

SHAREDATE

FINFORMEDVIATEXT/ FINFORMEDVIAEMAIL/FINFORMEDVIAPHONE/ FINFORMEDVIAPERSON/
FINFORMEDGRAPEVINE/ FINFORMEDVIAOTHER

MINFORMEDVIATEXT/ MINFORMEDVIAEMAIL/ MINFORMEDVIAPHONE/ MINFORMEDVIAPERSON/
MINFORMEDGRAPEVINE/ MINFORMEDVIAOTHER

NOCONTACT/NOTCLOSE/NOTCARE/NOTUPSET /NOTATRISK/WHATTOSAY/DIFFCOPING/TOOYOUNG/
NOTALKOTH

RELATIVESTESTINGRESULT1-4

RELMINFORMED

BREASTTESTS

PREVENTION

SEEKCANCERINFO

INFOSEEK

CANCERLEVELOFEFFORT/CANCERFRUSTRATED/CANCERCONCERNEDQUALITY/CANCERHARDTOUNDERST
AND

SHARECANCERWORRIES

SPEAKOPENLY

LISTENCONCERNS

ENCOURAGESHARE

COMFORTNO

OFFLIMITS

CHANGETOPIC

BECOMEANGRY

AVOIDTOPIC

ENCOURAGEFAMGENTESTING

ENCOURAGECHILDBROSISSCREEN

FAMWORRYFROMRESULTS

DESIRETODISCUSSGENTESTRESULTS

GENTESTRESULTRESPONSIBILITY

COMMINFLUENCESFAMDECMAKING

FAMDISCUSSHISTORY/ FAMDISCUSSTESTINGREASON/ FAMDISCUSSSCREENING/
FAMDISCUSSPREVSURGERY

FAMDISCUSSTESTFEELINGS/ FAMDISCUSSBRCA1/2GENE/ FAMDISCUSSBRCA1/2COST/
FAMDISCUSSINSURANCEDISCRIM

GENINFORESPONSIBLITY

PROVIDERRESOURCESFORFAMRISK

RESOURCESFORFAMRISK

RESOURCEHELPFUL

ENOUGHINFO

OTHERINFO

MARITALSTATUS

CURRINS

INSURTYPE

EDUCATIONGP

ORIENTATION

IDENTITY

HISPLATINOSPAN

HISPLATINOSPANGROUP

RACE

OCCUPATIONALSTATUS/ OTHEROCCUPATION

HOUSEHOLDINCOME

Gift Card

End screen