Questionnaire Copy 1

Patient Diagnosis Information

City

Country

Diagnosis *

Please select a diagnosis

Date of Diagnosis *

Please enter diagnosis date

Cancer Stage

Metastasis Details

Number of metastatic lesions

Number of organs with metastases

Note: ≤5 lesions in ≤2 organs = Oligometastatic (treated differently)

Current treatments

Current Line of Treatment *

Please select your current treatment line

Previous treatment lines you've completed

Previous drugs you're no longer taking

Driver Mutations

Location of tumors

Tumor Markers

Tumor markers available Tumor markers not available

Other Comorbidities

Tell us what you're already doing so we can personalize your report and avoid redundant recommendations.

Supplements you're currently taking

Off-label/repurposed drugs you're currently taking

Mind-body practices you're currently doing

Diet/metabolic approaches you're following

Exercise, sleep, or other foundational practices

Other integrative treatments you are currently doing