Patient Survivor and Survivor Cohort Submission Form

The Epidemiology and Genomics Research Program (EGRP) is compiling a list of cancer patient and/or survivor cohorts to foster awareness and encourage collaboration when feasible. If you have information about a cohort you would like to be considered for inclusion on this list, submit as much information as possible through the form below. For questions, contact Joanne Watters Elena, Ph.D., M.P.H.

Cancer Sites Represented:
Biological Specimens Collected:
Treatment Outcomes Measures:

Physician/Medical Record Reported


Co-morbidities at Study Entry:
Lifestyle Factors:
Treatment Data:
Treatment Data Assessed By:
Is the study open to collaboration?

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