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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 Baptist Memorial Hospital and Cancer Center-Memphis · Memphis, Tennessee

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 Memphis for study visits?