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My Cancer My Story

First things first, which of the following best describes you?

Current patient undergoing treatmentCancer survivor (completed treatment)Caregiver/family member

Name

First Name
Last Name*

Date of Birth:*

Sex:*

MaleFemale

Address:*

Street Address:*

Address 2:*

City:*
State / Province / Region:*

ZIP:*

E-mail:

Phone:

Best way to contact you:*

E-mailPhoneOther

Other:

Cancer Type:

Cancer Stage:

Current Cancer Status:

Did you receive tumor profiling by Caris Life Sciences?

YesNo

Who was your treating Oncologist?

Did you and your physician choose treatment based on the molecular characteristics of your tumor?

YesNo

Please provide a brief summary of your story below.

What piece of advice would you give other patients regarding molecular profiling?

Would you recommend tumor profiling?

YesNo

By sharing your information with us, you agree that a Caris Life Sciences employee may contact you about using your story for Caris Life Sciences’ promotional activities.

Yes

Face behind your story.

Upload a photo of you/your family.