Metastatic Uveal Melanoma (mUM) Patient Ad Board Recruitment

Screening Survey

Thank you for agreeing to participate in this screening survey. We ask you to please answer the following questions to help us determine your eligibility to participate in a patient-focused Advisory board. Participating in this screening survey is voluntary and any data collected will only be used for this limited purpose.

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* 1. Have you been diagnosed with uveal melanoma?

Yes

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* 2. Have you ever been told by a doctor that your uveal melanoma has spread to other parts of your body (metastasized)?

Yes

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* 3. Have you ever been tested for your HLA Type?

Yes

No, but I plan to request an HLA test

I don't know what an HLA test is

No, I do not intend to get an HLA test (please specify why)

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* 4. Were you told you were a candidate for KIMMTRAK® ?

Yes

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* 5. What treatment(s) did your doctor discuss with you as options to treat your metastatic uveal melanoma?

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* 6. What treatments are you currently taking for your metastatic uveal melanoma?

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* 7. Name

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* 8. Email

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* 9. How did you hear about this opportunity? (check all that apply)

Flyer at the Eyes on a Cure Symposium

Word of mouth

CURE OM email

VISION email

Social media

Other (please specify)