ACRIN 6689 Imaging Sub-study Survey

1. Please provide your contact information.

Please provide your contact information. Name:
Site:
Email Address:
Phone Number:

2. Please indicate your level of interest in working with imaging investigators to carry out the imaging sub-study ACRIN 6689.

Please indicate your level of interest in working with imaging investigators to carry out the imaging sub-study ACRIN 6689. Very interested

Somewhat interested

Not interested

Don't know at this time

Other (please specify)

3. Please provide the contact information, if known, for a potential MRI investigator who ACRIN could contact about activating the imaging substudy.

Please provide the contact information, if known, for a potential MRI investigator who ACRIN could contact about activating the imaging substudy. Name:
E-mail Address:

4. Please provide the contact information, if known, for a PET physician who ACRIN could contact about activating the imaging substudy.

Please provide the contact information, if known, for a PET physician who ACRIN could contact about activating the imaging substudy. Name:
E-mail Address:

5. Please provide any comments any additional comments you may have about the imaging substudy.

Please provide any comments any additional comments you may have about the imaging substudy.

Thank you for your time. Should you have any questions about the imaging substudy, please contact:

Bernadine Dunning; bdunning@acr-arrs.org
OR
Heather Homick; hhomick@acr-arrs.org