smidge1
01-30-2012, 05:51 AM
Hello!
We have a 60-minute telephone/online study for patients dealing with lung or colorectal cancer, renal cell carcinoma or glioblastoma in which the cancer has spread. The study takes place taking place throughout the day on February 6, 7 and 8.
If you qualify, please complete the following:
Name:
Age:
Ethnicity:
Phone number:
With which of the following cancers have you, or your loved one, been diagnosed?
( ) Lung
( ) Colorectal
( ) Renal cell carcinoma
( ) Glioblastoma
If you have lung cancer, is it small cell or non-small cell?
Has your cancer spread to other areas?
If it has spread, where has the cancer spread to? Is it a local spread, meaning it’s spread to the lymph nodes, or has it metastasized and spread to other places in the body, like the lungs, skin, bones, brain, liver, and/or other organs?
How long ago were you diagnosed?
Which of the following best describes how you/your loved one are treating the glioblastoma or cancer?
( ) Currently undergoing chemotherapy
( ) Have undergone chemotherapy in the past
( ) Have never undergone chemotherapy but are currently or planning eventually to undergo chemotherapy
( ) Have never undergone chemotherapy and neither scheduled nor eventually planning to undergo chemotherapy
Do you have health insurance?
What is you current experience with Avastin:
( ) Currently taken Avastin
( ) Taken Avastin in the past
( ) Never taken Avastin but considering taking it
( ) Never taken Avastin and am not considering it at this time
A recruiter will contact you if you can be considered for this study.
Thanks! No calls!
Brian Gordon
Probe Research
212-922-9777
888-454-5417
Fax: 212-504-8201
www.probemarket.com
We have a 60-minute telephone/online study for patients dealing with lung or colorectal cancer, renal cell carcinoma or glioblastoma in which the cancer has spread. The study takes place taking place throughout the day on February 6, 7 and 8.
If you qualify, please complete the following:
Name:
Age:
Ethnicity:
Phone number:
With which of the following cancers have you, or your loved one, been diagnosed?
( ) Lung
( ) Colorectal
( ) Renal cell carcinoma
( ) Glioblastoma
If you have lung cancer, is it small cell or non-small cell?
Has your cancer spread to other areas?
If it has spread, where has the cancer spread to? Is it a local spread, meaning it’s spread to the lymph nodes, or has it metastasized and spread to other places in the body, like the lungs, skin, bones, brain, liver, and/or other organs?
How long ago were you diagnosed?
Which of the following best describes how you/your loved one are treating the glioblastoma or cancer?
( ) Currently undergoing chemotherapy
( ) Have undergone chemotherapy in the past
( ) Have never undergone chemotherapy but are currently or planning eventually to undergo chemotherapy
( ) Have never undergone chemotherapy and neither scheduled nor eventually planning to undergo chemotherapy
Do you have health insurance?
What is you current experience with Avastin:
( ) Currently taken Avastin
( ) Taken Avastin in the past
( ) Never taken Avastin but considering taking it
( ) Never taken Avastin and am not considering it at this time
A recruiter will contact you if you can be considered for this study.
Thanks! No calls!
Brian Gordon
Probe Research
212-922-9777
888-454-5417
Fax: 212-504-8201
www.probemarket.com