You are being asked to take this survey about your experience as a patient, or caregiver of a patient with lung cancer to gather information about 
- How prepared patients are for making difficult decisions?
- How involved patients are in the decision process?
- What would help to improve the decision making process?
 
This information will help provide feedback to lung cancer doctors.  

The survey consists of 17 multiple choice questions, and can be done in approximately 15 minutes but there are spaces available for longer answers if you wish.

Possible discomforts or risks of completing this survey include reminding you of difficult prior experiences.

This survey request is going out to hundreds of patients.  Dr Gaspar will receive your answers anonymously.  Every effort will be made to protect your privacy and confidentiality. Please do not put personal identification information (name, phone number, etc) , or physician or institution names in your answers to the survey questions.  The information you send may be looked at by people at the Colorado Multiple Institutional Review Board (COMIRB) and other officials at the University of Colorado who are in charge of following all the rules for research, and by Dr Gaspar and her team of researchers.  Dr Gaspar might talk about the survey results at meetings and she might also have the results printed in relevant journals.  Even if known, we would not use any information that could identify you, such as your name, or the names of your physicians or hospital. 
You have the choice about being in this study.  You do not have to be in this study if you do not want to be. 

If you have questions about this survey please contact

Dr. Laurie Gaspar
Professor of Radiation Oncology
University of Colorado
720-848-0154
Laurie.Gaspar@ucdenver.edu.

This study, COMIRB 15-1642, has been approved by the Institutional Review Board of the University of Colorado.  You may have questions about your rights as someone in this study.  If so, you can call the COMIRB (the responsible  Institutional Review Board).   Their number is (303) 724-1055.
 
Thank you very much for your time.
Version Date: November 25, 2015

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