The Lung Cancer Policy Network interactive map: contribution form

Question Title

* 1. Contact information

Name *

Affiliation

Country

Email address *

Question Title

* 2. What type of entry are you submitting?

Clinical trial (randomised controlled trials)

Implementation study (feasibility studies, pilots and uncontrolled trials)

Regional or national organised screening programme

Question Title

* 3. What is the name of the trial, study or programme?
Official name of the of the initiative you'd like to contribute to the map and acronym it is commonly referred to as (e.g. NLST).

Question Title

* 4. Key information

Please provide some key information about the initiative, including:

The core aim(s) of the initiative

The coordinating centre or primary site where the initiative is located

Target number of participants for recruitment

The year in which the study started and is planned to end

Question Title

* 5. Are you working on this trial, study or programme?

Yes, I am the principal investigator or part of the research team for this initiative

No, I am not directly involved in this initiative

Question Title

* 6. Consent to be contacted

I consent to being contacted by The Health Policy Partnership on behalf of the Lung Cancer Policy Network, regarding the information I have shared in this form.

The Lung Cancer Policy Network interactive map: contribution form

Question Title

* 1. Contact information

Question Title

* 2. What type of entry are you submitting?

Question Title

* 3. What is the name of the trial, study or programme?Official name of the of the initiative you'd like to contribute to the map and acronym it is commonly referred to as (e.g. NLST).

Question Title

* 4. Key informationPlease provide some key information about the initiative, including: The core aim(s) of the initiative The coordinating centre or primary site where the initiative is located Target number of participants for recruitment The year in which the study started and is planned to end

Question Title

* 5. Are you working on this trial, study or programme?

Question Title

* 6. Consent to be contacted

* 3. What is the name of the trial, study or programme?
Official name of the of the initiative you'd like to contribute to the map and acronym it is commonly referred to as (e.g. NLST).