11. Is there a history of breast cancer among your 1st degree blood relatives (i.e., mother, full sister or daughter)?
    No Yes, sister(s) Yes, mother
    Yes, daughter(s) Unknown
    If Yes:
    • Were any of them diagnosed before age 50? Yes No Unknown
    • Were both breasts involved for any of them? Yes No Unknown
12. Your approximate height:
    ____cm or ___ft___in
13. Your approximate weight:
    ____kg or ____lbs

New Brunswick Breast Cancer Screening is trying to reach as many New Brunswick women as possible. To do this we need to know which groups of women we may be missing. Please help us assess our recruitment and advertising methods by answering these questions:

14. What is the highest level of education you have attained? (Please check only one answer)
    Grade 9 or less Some high school High school diploma
    College/Some university University degree
15. In your paid job, what is (or was) has your main occupation been? (Please check only one answer)
    farming/fishing/processing sales/services clerical
    management professional other
16. Where did you hear about the breast screening services? (Please check all the answers that apply to you)
    doctor friend/relative
    invitation letter magazine/newspaper
    poster/pamphlet radio.
    television other please specify ______________
17. Of all the ways you heard about the Breast Screening Services, which one convinced you to come for screening? Underline the most important one in the list above.

Appendix A - Table of Contents