Section A. Personal and Professional Background

Many patients seek out and spend money on supplementary care, including talk therapy, massage, yoga and acupuncture to help them cope with cancer without clear evidence to support their various health claims.

To improve the evidence-base and quality of care provided to patients, we want to learn more about the potential risks and/or utility of yoga from a clinician’s point of view.

Thank you for your important contribution.

All personal information and your responses will remain entirely confidential.

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1. Your Last Name, First Name and Initial

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2. Are you male or female?

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3. What is your date of birth?

Date

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4. Please provide your e-mail address (for related-research inquiries only):

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5. What ethnicity best describes you:

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6. Do you consider yourself Christian, Jewish, Buddhist, Muslim, Hindu, a follower of some other religion, or not religious?

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7. What is your current professional title?

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8. What is your medical sub-specialty? (if applicable)

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9. How many years have you been practicing medicine?

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10. Do you practice medicine on a part-time or full-time basis?

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11. Where is your treatment hospital and/or clinic located?

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12. What proportion of your patients are adults (18 years of age or older)?

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13. How many new cases of cancer do you see?

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14. What type of cancers do you most often treat?
Please rank them in order of 'most' treated at the top and 'least' treated at the bottom:

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15. How would you describe your level of physical fitness with respect to the general population?

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16. What kind of physical activity or sport do you currently enjoy to promote your level of fitness or well-being?

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17. How often do you practice yoga?

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18. How often do you partake in any meditation or mindfulness-based practices?

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19. How would you describe your commitment to using complementary or alternative medicine (CAM) to improve your own personal health?

  Not at all committed Somewhat committed Neutral Committed Very committed
Level of commitment to CAM for your personal health

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20. In the past, what kinds of complementary therapy have you used for your own personal health?

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21. How would you describe your level of interest in using complementary or alternative medicine (CAM) to improve health-related outcomes in your patients?

  Not at all interested Not very interested Neutral Somewhat interested Very interested
Level of interest in CAM for your cancer patients

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22. In the past, what kinds of complementary or alternative medicine have you suggested to your patients to improve their health-related outcomes?

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23. In general, how would you describe your attitude towards yoga as a means to improve health or well-being?

  Very negative Somewhat negative Neutral Somewhat positive Very positive
Attitude towards yoga for health or well-being

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24. How would you describe your level of interest in using yoga to improve health-related outcomes in your cancer patients?

  Not at all interested Not very interested Neutral Somewhat interested Very interested
Level of interest in yoga for your cancer patients
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