Share Your Clinical Trial Experience With NBTS

Have you or a loved one enrolled in a clinical trial after a brain tumor diagnosis?

NBTS wants to connect with a small number of patients and caregivers who have gone through the process.

If you’re willing to share your experience for possible inclusion in future NBTS content, please complete the form below.

Name(Required)

First Last

Email:(Required)

Phone(Required)

Where are you from?(Required)

City State

Did you or a loved one enroll in a clinical trial?(Required)

Other:

Are you comfortable sharing your clinical trial experience with NBTS for possible inclusion in future content?(Required)

Would you be comfortable sharing your experience in a video?(Required)

Other:

What was your clinical trial evaluating?(Required)

Why did you decide to enroll in a clinical trial?(Required)

Please share your connection to brain tumors.(Required)

Other connection to brain tumors:

Which tumor type best describes your diagnosis or the diagnosis of your family member or friend?(Required)

Other diagnosis (or unknown):

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