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Intake questionnaire

The PREDICT Registry:

Applying to UT Southwestern Medical Center · Dallas, Texas

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

0 of 4 answered

1. Are you between 30 and 85 years old?

YesNo

2. Do you identify as female?

YesNo

3. Have you been diagnosed with DCIS?

YesNo

4. Are you able to travel to Dallas for study visits?

YesNo

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Completing a questionnaire on Clinably does not enroll you in a clinical trial or confirm your eligibility. Only the research team can determine whether you meet the criteria to participate. Results are based on the information you provide and are intended to help you start a conversation with the research team.

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