Exit this survey

Thank you for completing the online Inherited Cancer Risk program. Once you complete this survey we will be able to validate your participation in the online class and update your Kaiser Permanente medical record.

Question Title

* 1. First Name:

Question Title

* 2. Last Name:

Question Title

* 3. Please enter your Kaiser Medical Record #:

Question Title

* 4. Please select the city where your main Kaiser Permanente Medical Center is located:

Question Title

* 5. Are you interested in scheduling a genetic counseling visit to review your family history?

( Privacy & Cookie Notice

T