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What is the primary way you heard about the 2026 ZERO Education & Support Conference?[select one] Please Select Email from ZERO ZERO website ZERO online communities Email from another organization Attended a previous ZERO event Healthcare provider (doctor, nurse, office materials, social worker, etc.) Advertisement ZERO social media Word of mouth/colleague/family member/friend
What is your primary connection to prostate cancer? [select one] Please select Prostate cancer patient/survivor Care Partner/Caregiver Family member or friend of a patient/survivor of prostate cancer I’ve lost a loved one to prostate cancer Healthcare professional ZERO sponsor or partner ZERO Staff I have no connection to prostate cancer Other
If you are a patient or survivor, how would you describe your prostate cancer? [select one] Please select Early Stage or Localized (cancer is contained entirely in the prostate) Locally Advanced or Regional (cancer has spread from the prostate to nearby lymph nodes, but no farther) Advanced or Metastatic (cancer has spread to other parts of the body, such as bones, liver, lungs, etc.) I don’t know I prefer not to answer I am not a patient or survivor Other
Which racial or ethnic group do you identify with? [select one] Please select Asian Black or African American Hispanic or Latino Middle Eastern or North African Native American or Alaskan Native Native Hawaiian or Pacific Islander White or Caucasian Multiracial or Biracial A race/ethnicity not listed here Prefer not to answer Other
Are you a U.S. military Veteran or on active duty? [select one] Please select Yes No Other
Please describe any assistance or accessibility requirements you may need to fully participate in the event (e.g., an ASL interpreter, closed captioning).
Are you interested in learning about opportunities to use your story to advance policies for prostate cancer patients and their families? This includes email action alerts that keep you updated on ZERO's legislative efforts and offer you the chance to take action. Please select Yes No Other
How familiar are you with the support resources available to people affected by prostate cancer? How connected do you feel to the broader prostate cancer community? How would you classify your knowledge about the current standard of care for prostate cancer treatment? How confident are you in your ability to manage or support the management of prostate cancer treatment side effects? phi chi sigma
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