Specialist Survey
Please fill out this form and we will be in touch.
Name
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First Name
Last Name
Email
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example@example.com
Professional Title
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Institution Name
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Specialty
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Please Select
Medical Oncology
Surgical Oncology
Other
Specialty - Other
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Which of the following programs would you like to be listed as a specialist on our website?
GIST
TGCT / GCT
Liposarcoma
None
How many GIST patients have you seen in the past year?
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Are you actively engaged in GIST research?
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Please Select
Yes, I published research papers on GIST.
Yes, I have not published research papers on GIST but I actively engage in research.
No
Other
If you selected "Other", please explain your response.
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Do you perform routine mutational testing?
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Yes
No
Please list the laboratories that you use for mutational testing:
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If a patient experiences progression and/or is not responding to medication, do you follow up with additional mutational testing? (Please be specific about the type of testing such as repeated NGS, ctDNA, etc.)
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Have you referred any of your patients to a clinical trial site?
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Yes - Onsite Clinical Trials
Yes - Offsite Clinic Trials
Yes - Onsite & Offsite Clinical Trials
No
How many TGCT patients have you seen in the past year?
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Do you perform limb salvage surgeries?
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Yes
No
Do you specialize in upper extremity or lower extremity procedures?
Upper Extremity Procedures
Lower Extremity Procedures
Both
Are you actively engaged in TGCT research?
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Please Select
Yes, I published research papers on TGCT.
Yes, I have not published research papers on TGCT but I actively engage in research.
No
Other
If you selected "Other", please explain your response.
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Have you referred any of your patients to a clinical trial site?
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Yes - Onsite Clinical Trials
Yes - Offsite Clinic Trials
Yes - Onsite & Offsite Clinical Trials
No
How many liposarcoma patients have you seen in the past year?
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What sub-types of liposarcoma do you specialize in? (please select all that apply)
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Well Differentiated/Dedifferentiated
Myxoid / Round Cell
Pleomorphic
Are you actively engaged in Liposarcoma clinical research?
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Please Select
Yes
No
Are you actively engaged in Liposarcoma basic/translational research?
*
Please Select
Yes
No
Do you have a multi-disciplinary team that has experience working with sarcoma patients?
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Yes
No
Multi-Disciplinary Team (Please "Add New" for each member of the team)
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Please feel free to include any other relevant information or comments below.
Please verify that you are human
*
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