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Intake questionnaire

S1501 Dual Observational and Randomized Cohort Study of Patients With Metastatic HER-2+ Breast Cancer at Risk of Cardiac Toxicity

Applying to UT Southwestern/Simmons Cancer Center-Dallas · Dallas, Texas

Answer a few short questions to share with the research team.

0 of 4 answered

1. Are you 18 years old or older?
2. Have you been diagnosed with Cardiotoxicity?
3. Are you currently pregnant or breastfeeding?
4. Are you able to travel to Dallas for study visits?