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Patient Intake Form – PSMA

Patient Intake Form – PSMA

Thank you for your interest in our PSMA treatment for advanced prostate cancer. We want to help you find out if PSMA is the right treatment for you. Please complete our patient intake form so we can learn more about your healthcare journey.

To receive the PSMA treatment under current guidelines, patients will need to have been treated with androgen receptor (AR) pathway inhibition, along with at least one taxane-based chemotherapy treatment.

We encourage all prostate cancer patients to complete this form as we have alternative treatments available, and the clinical guidelines for PSMA may change as further research emerges. We would like to remain in communication to keep you updated.

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