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 The Form Builder is available to users who agree to the PRO-CTCAE Terms of Use.

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User Questionnaire

Please take the time to answer a few questions about your use of PRO-CTCAE. The information you provide will help us understand how people are using PRO-CTCAE, and to improve it in the future. If you provide your e-mail address, we'll send you a link that you can use to come back to your pre-built form anytime.

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Study design (select one)

Is the study NCI/NIH Sponsored?
PRO-CTCAE items needed You will have the opportunity to revise these choices on the next page.

Oral







Gastrointestinal













Respiratory




Cardio/Circulatory



Cutaneous
















Neurological



Visual/Perceptual






Attention/Memory



Pain





Sleep/Wake



Mood




Gynecologic/Urinary










Sexual







Miscellaneous









Languages requested You will have the opportunity to revise these choices on the next page.