Exon 20 Group Membership

Intake Form

If you are a patient, clinician or scientist, membership is free of charge.
Patients and their families are welcome to join the Exon 20 Group.

Please help us schedule an introductory phone call

We would like to schedule a phone call with you to introduce you to the Exon 20 Group and our direct patient navigation services, our Molecular Tumor Board services, and our clinical trials matching services. Please let us know the best time to reach you, Monday thru Sunday, between 1 p.m. and midnight, Eastern time.

Exon 20 Group Membership Intake Form

Willing to travel for a clinical trial?

Current/Other Regimens

Imaging Dates

Interests

Please print a copy of your responses before submitting the form   Print a Copy

 

The Exon 20 Group is entering its seventh year of serving EGFR exon 20 and HER2 exon 20 and HER2 lung cancer patients across the world. Both mutations can be found in numerous cancer types in addition to lung cancer, so we also welcome patients and families with any tumor type. We are a multi-stakeholder coalition (72 countries plus) specializing in every detail of the patient's exon 20 journey. Our members include patients, care partners, family members, thoracic oncologists in academia, medical oncologists in community medical centers, oncology nurses and clinical research coordinators, molecular profiling laboratories, and the research and development arms of academia, pharma, and biotech—all working toward the cure.

We require an onboarding phone call with each Exon 20 Group member. We specialize in direct patient navigation, oncology nursing services and side effects management, clinical trials matching services, and compassionate use matching services. Our services are free. We want to talk to you as soon as possible but we also schedule by the urgency of a patient case.

Our Facebook sites (20 and counting) are closed and private for patients or their chief care partner / family member. To admit you into our Facebook group, we require an onboarding phone call before you are admitted. If you apply to our Facebook group without first having had an onboarding call, we would understandably need to automatically decline you until after the call.

We need to depend on you to contact us if you do not hear back from us once you submit this form. If you have not heard back in 48 hours, we need you to call 602-618-0183 or email us at cancerpatientadvocacy@gmail.com

Never doubt that the mission of the Exon 20 Group is to turn this disease into a manageable disease and then cure it completely.

Thank you! We look forward to welcoming you and helping you extend life with quality of life.

Robert T. Hanlon, PhD, Co-Founder and Chairman
Marcia K. Horn, JD, Executive Director
Carmi Fazio, RN, Oncology Nursing
Kristen Leniz, Patient Advocate
Susan Johnson, Patient Advocate
Caren Suesserman, Patient Advocate
Lauren Conley, Patient Advocate
Katina Bland, Patient Advocate