Submit a Study

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Submit a Study

If you are involved in a study or you know about one that is relevant to young women affected by breast cancer, please fill out the form below. If we have further questions, we will contact you or the individual indicated as the contact person.

Once reviewed and approved by our Research/Advocacy Advisory committee, you will receive a notification. We will then post the study on our website and alert our survivor constituency to ensure that young women affected by breast cancer are aware of all studies available to them.

Your Name:

Title (if applicable):

Institution (if applicable):

Home Address:

City:

State:

Zip Code:

Country (if not US):

E-Mail Address:

Phone Number:

Fax Number:

Study Name:

Institution/Researcher:

Is this study IRB approved?

If not, is approval pending?

Purpose of Study: Briefly indicate the purpose of the study and the primary research endpoints. This summary will be used for YSC website posting of the study.

Eligibility Criteria:

Website for more information (if applicable):

Additional Comments about the study:

If you are not the person to contact for more information on the study, please indicate who the YSC can contact (usually a primary investigator or study coordinator):

Name:

Title/Affiliation:

Phone Number:

E-Mail Address:

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