BCAN Bladder Cancer Community | Veteran Connection Survey

Advocating for our service members and their families

BCAN is committed to continue advocating for the active duty servicemembers, veterans and their dependents in our community. We need your help. We are gathering information to identify who we can serve better in the future, and how. Please help us know who you are, when and where you served, and what BCAN can do to help you on your bladder cancer journey. This information will help guide our future programs and advocacy/outreach activities. Your responses are confidential and only used to guide BCAN programs and services. Thank you in advance for filling out this survey.

1.Who/Where are you?

First name

Last name

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

2.What is your connection to the military?

I currently serve in the US military

I am a veteran of the US military

I am a dependent of someone who is/was in the US military (please answer the following bladder cancer specific questions on behalf of the service member)

I am a healthcare provider that works with the VA hospital system.

Other (please specify)

3.What is your (your loved one's) connection to bladder cancer?

Had/have a non-muscle invasive bladder cancer diagnosis

Had/have a muscle invasive bladder cancer diagnosis

Had/have a UTUC diagnosis

Had/have a advanced/metastatic bladder cancer diagnosis

Other (please specify if different from options above)

4.Where are/were you being treated for your bladder cancer?

A Veterans Administration (VA) hospital

A community urologist practice

A community hospital

A large teaching hospital

Please specify:

6.When did you serve?

Year you entered the military

Year you were discharged/retired from the military

8.Military personnel are exposed to environmental hazardous substances that can be very different from those for industry workers and for the general population. Which of the known or suspected cancer risk factors were you exposed to during your service? (check all that apply)

Other (please specify)

9.Please provide suggestions for how BCAN can help our military community with their bladder cancer journey.

10.Thank you for sharing this information with BCAN. Please indicate which activities you wish to be invited to participate in.

Military and bladder cancer webinar programs

Advocacy at the Federal or State level

BCAN Speakers Bureau

Outreach to VA medical centers

Sharing your military bladder cancer story on BCAN.org

Other (please specify)