This form will guide you through a series of questions designed to help you craft a personalized letter about your cancer history to the clinician of your choice. None of the information you enter is saved on a server or accessible by any other party. When you are finished, you will select an option to email yourself the completed PDF, which you can then save to your files and share with your clinician. You will be reminded to review your entries carefully before sending the letter to yourself, as there will not be an option to edit the letter, unless you have access to PDF-editing software.
Please click here to see sample document.