Thank you for taking a few moments to complete this short survey!

As we look to restructure and strengthen our CURE OM Ocular Melanoma (OM) support groups, we want to ensure we have the most up-to-date information for all patients and caregivers who wish to remain connected and involved. Your input will help us tailor the group to better meet the needs of our community.
If you have any questions, please don’t hesitate to reach out to us at cureom@melanoma.org.

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* 1. What is your first name?

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* 2. What is your last name?

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* 4. Please provide your mailing address.

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* 5. What is your relationship with ocular melanoma (OM)?

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* 6. Have you attended an Ocular Melanoma Support Group in the past?
(If yes, please select which group you’ve attended)

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* 7. If you’ve joined the OM Support Group before, are you interested in continuing to be part of the group moving forward?

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* 8. What topics or themes would you find most helpful or meaningful to explore during our support group sessions?

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* 9. Please share your year of diagnosis:
(Select the range that best applies)

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* 10. Where have you received care for your ocular melanoma?
Please list your ocular oncology team and, if applicable, your medical oncology team or any other specialists involved in your care.

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* 11. If you are not currently subscribed to the MRF’s Quarterly Eye on OM CURE OM Newsletter, would you like to be added?
(A quarterly update from the MRF’s CURE OM initiative featuring research highlights, advocacy efforts, patient stories, events, and more.

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* 12. Would you like to subscribe to MRF's Monthly SPOTlight newsletter?
(Stay up to date on the latest news, educational resources, events, and research across all types of melanomas)

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