CANTRIA Intro - Mesothelioma Group

mesothelioma clinical trials

Result of Initial Telephone Call Attempt
- Call answered
- Call not answered - Voicemail
- Call not answered - No Voicemail

Voice Mail Message

Introduction
Target Contact Reached or Not*
- Target Contact reached
- Target Contact is not available

Request to Leave Message
Ok, as I mentioned, my name is Max Spiro and I am a Mesothelioma Clinical Trial Navigator with CANTRIA. NAME completed an online contact form and requested a call back. Would you mind taking a message for NAME?
- No - Contact will accept message
- Yes- Contact will not accept message

Contact Will Not Accept a Message
No problem. I will try NAME back another time. Thank you. Good bye

Talk Now or Later
Hello NAME, as I mentioned, my name is Max Spiro and I am a Mesothelioma Clinical Trial Navigator with CANTRIA. I received a notification that you completed an online contact form and requested a call back. Would this be a good time to spend a few minutes with me?
- Yes - Target Contact has time to talk
- No - Target Contact does not have time to talk

Schedule a Call Back
I understand. Would you mind scheduling a call with me for a later day or time?
- No - Schedule call back
- Yes - Unable to schedule a call back
- Yes - Unwilling to schedule a call back

Call Back Date
What would be a good day to try you back?
Date Format: MM slash DD slash YYYY
Call Back Time
And what time would be best for you?

: HH

MM

Cannot Schedule Call Back
I understand. May I leave my call back information with you. so that you may call me back when it's convenient for you?
- Yes - Will accept call back information
- No - will not accept call back information

Unwilling to Accept Call Back
I understand. I hope you enjoy the rest of your day. Goodbye

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Do you have mesothelioma or did you contact us on behalf of someone else?
If someone else: Is the person with mesothelioma a family member or a friend?
- I have mesothelioma
- Family member
- Friend
In what year was the original diagnosis made?
Leave blank if unknown
What type of mesothelioma was diagnosed? (read choices)
- Pleural (Malignant Pleural Mesothelioma)
- Peritoneal
- Pericardial
- Testicular
- I don't know
Do you know the cell-type or histology? (read choices)
- Epithelial
- Sarcomatoid
- Biphasic (mixed epithelial and sarcomatoid)
- I don't know
Is surgery a current option?
- Yes
- No
- I don't know

Is surgery planned?
- Yes
- No
- I don't know

Has there been any prior mesothelioma treatment?
- Yes
- No
- I don't know

Was standard or standard-of-care chemotherapy refused?
- Yes
- No
- I don't know

How many different types of chemotherapy have been administered??
- Zero (0)
- One (1)
- Two (2)
- Three (3)
- Four or more (4+)
- I don't know
Has all chemotherapy treatment ended?
- No
- Yes
- I don't know
What was the 1st or 1st-line of chemotherapy used?
The two most common would be: Pemetrexed (Alimta) and Cisplatin or Pemetrexed (Alimta) and Carboplatin
- pemetrexed/cisplatin (combination)
- pemetrexed/carboplatin (combination)
- pemetrxed/cisplatin/bevacizumab (combination)
- gemcitabine/cisplatin (combination)
- carboplatin (alone)
- cisplatin (alone)
- gemcitabine (alone)
- pemetrexed (alone)
- vinorelbine (alone)
- I don't know

What was the 2nd or 2nd-line of chemotherapy used?
The two most common would be: Pemetrexed (Alimta) and Cisplatin or Pemetrexed (Alimta) and Carboplatin
- pemetrexed/cisplatin (combination)
- pemetrexed/carboplatin (combination)
- pemetrxed/cisplatin/bevacizumab (combination)
- gemcitabine/cisplatin (combination)
- carboplatin (alone)
- cisplatin (alone)
- gemcitabine (alone)
- pemetrexed (alone)
- vinorelbine (alone)
- I don't know

What was the 3rd or 3rd-line of chemotherapy used?
The two most common would be: Pemetrexed (Alimta) and Cisplatin or Pemetrexed (Alimta) and Carboplatin
- pemetrexed/cisplatin (combination)
- pemetrexed/carboplatin (combination)
- pemetrxed/cisplatin/bevacizumab (combination)
- gemcitabine/cisplatin (combination)
- carboplatin (alone)
- cisplatin (alone)
- gemcitabine (alone)
- pemetrexed (alone)
- vinorelbine (alone)
- I don't know

What were the results of your last Scan or PET Scan?
Please answer this question based on the results of the last scan done. We recognize that you may have another scan scheduled or may be awaiting the results of a recent scan.
- There was less mesothelioma than the prior scan
- There was no progression since the prior scan (stable)
- The mesothelioma had progressed
- I don't know

Which of the following would best describe you?
- Fully active, able to carry on all pre-disease performance without restriction
- Restricted in physically strenuous activity but ambulatory and able to carry out work of a light or sedentary nature, e.g., light house work, office work
- Ambulatory and capable of all selfcare but unable to carry out any work activities. Up and about more than 50% of waking hours
- Capable of only limited selfcare, confined to bed or chair more than 50% of waking hours
- Completely disabled. Cannot carry on any selfcare. Totally confined to bed or chair
- I don't know
Has a legal case ever been pursued?
- Yes
- No
- I don't know
Is there a legal case currently pending?
- Yes
- No
- I don't know
What is (the patients) zip code?
If zip code is unknown, capture city and state

City State ZIP Code
Wrap Up
May we schedule that follow-up call now?
- Yes
- No
Great, what would be the best day for a follow-up call?
Try to schedule something approximately 24-48 hours from today.
Date Format: MM slash DD slash YYYY
And what would be the best time of day for that?
Make sure to schedule using Mountain Time

: HH

MM
You indicated that a legal case has not been pursued in this matter. Is this something that you might be interested in pursuing? I ask because we are funded by a great legal firm and if your interested, I could have someone contact you about legal options. Would you be interested in hearing from someone?
If asked, the name of the firm is Maune Raichle Hartley French & Mudd
- Yes - Contact me
- No - don't contact me
Unable to Schedule Follow-up
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