CAR-T Therapy Survey 2020
Questions marked with a * are required
100%
1. Which best describes your role with CLL? 
2. What is your age?
3. What is your gender?
4. Please specify your race and ethnicity; select all that apply:
5. What is your or the CLL patient’s status of treatment for CLL?
6. Regarding the prognostic and predictive factors, I or the patient have: 
Yes
No
Don't know / not sure
Prefer not to say
Deletion 17p
TP 53 Aberration
Deletion11q
IgVH Unmutated (also known as unmutated status)
Complex Karyotype
NOTCH1
Please take a moment to complete the questions below regarding current knowledge and thoughts about CAR-T Therapy, also known as Chimeric Antigen Receptor-T Cell Therapy. 
7. I am confident in my understanding of how CAR-T Therapy works.
8. I am confident in the safety of CAR-T Therapy.
9. I am confident in the effectiveness of CAR-T Therapy.
10. I am confident in my understanding about when someone should consider finding a clinical trial for CAR-T Therapy as a CLL patient. 
11. I have had CAR-T Therapy.
12. I am currently considering CAR-T Therapy as my next line of treatment.
13. What would you like to see CLL Society do to help further CAR-T Therapy knowledge or access for CLL patients?