ROS1+ Facebook Group
Thank you for your interest in joining the ROS1+ Facebook Group. We're glad you found us.

This group is exclusively for people with a ROS1 driven cancer and/or their caregiver. Please fill out this form to tell us about your cancer experience. Be aware that we will share this information with members of the group, but the group is "secret" according to Facebook practices. Visit this link for an explanation of a "secret" group. https://www.facebook.com/help/220336891328465

What about Privacy?
Privacy is obviously a concern. We understand that even with the Facebook group, anyone could copy/paste the content and republish. As far as we know, this has never happened. This is a tremendously helpful group with excellent goodwill. We hope to keep it that way. With that in mind, please understand that while answers here will be shared within the group and would never be shared beyond the group without explicit request and authorization, it is impossible to safeguard the data 100%. If at any point you would like to remove your data from the form, we will kindly do so as quickly as possible.

** Remember to click JOIN GROUP on the Facebook page or we will not be able to process your entry. **

First Name *
Your answer
Last Name *
Your answer
Facebook Name *
Your answer
Are you the patient or a caregiver? Either the patient OR caregiver should fill out this form, not both. *
If you are the caregiver, what is the patient's name?
Your answer
What type of cancer do you have? *
What stage is your cancer? *
What was your age at diagnosis?  *
Your answer
At which facility or hospital is your ROS1 cancer being treated? *
Your answer
Where do you live? Please include the city and country. *
Your answer
Your First Line Treatment
The questions below refer to the first treatments you received for your cancer.
Type of treatment (include names of drugs, location of radiation or surgery, or other details if possible) *
Your answer
Is this part of a clinical trial? *
When did you start this treatment? *
Your answer
When did you stop this treatment? *
Your answer
Why did you stop this treatment? *
Your Second Line Treatment
Type of treatment (include names of drugs, location of radiation or surgery, or other details if possible)
Your answer
Is this part of a clinical trial?
When did you start this treatment?
Your answer
When did you stop this treatment?
Your answer
Why did you stop this treatment?
Your Third Line Treatment
Type of treatment (include names of drugs, location of radiation or surgery, or other details if possible)
Your answer
Is this part of a clinical trial?
When did you start this treatment?
Your answer
When did you stop this treatment?
Your answer
Why did you stop this treatment?
Is there anything else you would like to tell us?
Your answer
How did you hear about this group? *
Your answer
Feedback and Follow-up
Receive update reminders?
Would you like to receive a 6-monthly reminder to update your details. This helps us to keep our database up-to-date.
Receive invites for follow-up surveys
Sometimes, we get specific questions from researchers not covered in this survey. Would you be willing to participate in such sporadic and small surveys?
Your email
Your answer
** Remember to click JOIN GROUP on the Facebook page or we will not be able to process your entry. **
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