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Dear patient partner,

If you would like to express your interest and contribute your ideas to the research conducted by the EORTC Cutaneous Lymphoma Group, please complete the form below.
 
Thank you very much!
Sincerely yours,
Iryna 
 
EORTC Patient Relationship Manager
iryna.shakhnenko@eortc.org

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* 1. Your title

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* 2. Your name and last name

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* 3. Country of residence

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* 4. E-mail address 

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* 5. Have you had any personal experience of clinical trials or cancer research projects?

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* 6. Are you familiar with the clinical trial process?

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* 7. Do you represent or are affiliated with any patient organisation?

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* 8. Your comments, questions, or suggestions

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* 9. I hereby give EORTC my consent to process my personal data for the purpose of participation in the activities of the EORTC Group of Patient Partners.
Our privacy policy: https://www.eortc.org/privacy-policy/

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