FORCE Peer Navigation Program

Welcome to the FORCE Peer Navigation Program. This program is only available for people from the United States and Canada. Please fill out this confidential survey so that we can try to match you to someone as much like yourself as possible. Once you submit your information, a FORCE peer navigator volunteer will follow up within 1 week by email or will call or text if they do not receive a reply email from you. Our goal is to provide you with resources that will empower you to make informed decisions about your health care with your doctors. Thank you for reaching out to FORCE.

Acknowledgement

Contact Information









Does FORCE have your permission to leave a voice mail if we cannot reach you by email?*
Demographics: If you are a caregiver, please complete this survey for the person you are supporting.  




Do you have a family history of cancer?*
Have YOU, yourself, ever been diagnosed with cancer? Or if you are a caregiver answer for the person you are supporting and also select I'm a Spouse/Partner.  



Have you had genetic counseling?*
Genetic test results:


Which topic(s) interest(s) you?






Additional questions to help us assess your needs (optional)


FORCE Information




                                          
If you click Submit, and it stays on this screen, scroll up to make sure that you answered all questions that say "This field is required." and that there are no other error messages in red.