Help Us Better Understand GBM

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We are seeking patients with Gliblastoma Multiforme (GBM) and/or their caregivers to participate in a market research study discussing your treatments and experiences. The feedback will be used to help future patients and their caregivers.

If you were diagnosed with GBM less than 15 months ago and are currently receiving treatment, you may qualify to participate.

If you qualify and complete an 30-minute online survey, you will receive $75 for your time and participation. All information and responses will remain confidential.

First & Last Name *

Email Address *

Phone number *

Please select one of the below statements: *

I have been diagnosed with glioblastoma multiforme

I care for someone who has been diagnosed with glioblastomamultiforme

Neither of the above statements apply to me.

Do you, or does anyone in your household, currently work in any of the following types of businesses? Please select all that apply. *

Market Research

A manufacturer, distributer or retailer of over-the-counter or prescription medication or medical equipment

Pharmaceutical company

Hospital or Clinic

Doctor or doctor’s office

Government Health Agency

None of the above

Required

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