Your Information

What type of cancer have you been diagnosed with?

Type of Cancer*

Select the ways you'd like to participate from the options below*

Medical Record Donation

Your medical records will be carefully de-identified and used to advance cancer research. This helps researchers understand patterns in diagnosis, treatment, and outcomes.

Medical Records Only

Records must be in the United States

✓ Includes Pattern's base data collection fields
✓ Records will be de-identified
✓ Records must be in the United States

Surgical Tumor Tissue Donation

Cancer research often needs fresh tumor samples from surgeries to support research that requires living tumor tissue, such as creating models and cell lines.

Upcoming Surgery

Surgery must be in the United States

✓ For surgery in the next 6 months
✓ Includes medical record donation

Fluid or Fluid Donation

Fluid samples from cancer patients can provide valuable insights into cancer progression and treatment effectiveness.

Upcoming Fluid Collection

Collection must be in the United States

✓ For fluid or pleural effusion collection in the next 6 months
✓ Includes medical record donation

Stored Tumor Tissue Donation

Previously stored tissue samples can be valuable for retrospective studies and comparing treatment outcomes.

Stored Tissue From Past Surgery

Surgery must have been in the United States

✓ We will try to collect stored tissue from the institution where you had a surgery in the past.
✓ Includes medical record donation

Patient First Name*

Patient Last Name*

Email*

Confirm email*

Phone*