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CNS/Brain Metastases Patient Survey
Your Voice Matters
WHAT?
The organizations above are partnering with the American Brain Tumor Association on an important survey-based project focused on the experiences and needs of people living with brain metastases and/or leptomeningeal disease (also known as LMD or Lepto).
WHY?
Your input is vitally important and will help us develop programs to support people living with and caring for people who have cancer.
WHO?
If you have been diagnosed with brain metastases and/or leptomeningeal disease
and
live in the United States, we would love to get your perspective. (It is fine to have someone like a caregiver or a member of your family help you to complete the survey.)
WHEN?
Within two weeks of providing your email address, you will receive a link to take the survey.
HOW?
Links to the survey are being distributed individually via email. To request your survey link, fill out this brief form.
IMPORTANT INFO:
Participation is voluntary and all collected information is anonymized and kept confidential. People who complete the survey will be compensated.
Survey Participation & Data Protection Consent
As part of this research which is being conducted by Ipsos-Insight, LLC, (a specialized research agency based in the United States) your email address will be shared with TriVoca Health, a partner agency assisting in running the research survey. Your email address will be used ONLY to send you the survey link and to send you your honorarium if you complete the survey.
As members of the Insights Association, ESOMAR, and EphMRA, we adhere to their Market Research Code of Conduct, regulations, and guidelines. We assure you that your email address will be treated with the utmost confidentiality.
Consent Confirmation:
We kindly ask for your authorization and consent:
Please indicate your preference:
Select one
checkbox
radio
I agree
to allow TriVoca, a partner agency assisting in running the research survey, to collect and share my email address for the exclusive purposes mentioned above.
I do not agree
to allow TriVoca, a partner agency assisting in running the research survey, to collect and share my email address for the exclusive purposes mentioned above.
To request your survey link, please fill out the following form.
checkbox
radio
First Name:
Last Name:
Email:
Please confirm email:
Feel free to reach out to
nestor.gongora@trivoca.com
in case of any issues with this landing page or if you have any questions.