FORCE Peer Navigation Program

Welcome to the FORCE Peer Navigation Program. This program is only available for people from the United States and Canada. Please fill out this confidential survey so that we can try to match you to someone as much like yourself as possible. Once you submit your information, a FORCE Peer Navigator Volunteer will follow up with you within one week by email. Our goal is to provide you with resources that will empower you to make informed medical decisions with your healthcare providers. Thank you for reaching out to FORCE.

Contact Information

What is your time zone?
What time of day is best to reach you? (morning, afternoon, evening or share specific times)
Does FORCE have your permission to leave a voice mail if we cannot reach you by email?
Have you communicated with a Peer Navigator before?
Demographics: If you are a caregiver, please complete this survey for the person you are supporting.  

Have YOU, yourself, ever been diagnosed with cancer? Or if you are a caregiver, answer for the person you are supporting.  

Have you had genetic counseling?
Do you have a family history of cancer?

Genetic test results:

Which topic(s) interest(s) you?

Additional questions to help us assess your needs (optional)

Do you want to request an American Sign Language Interpreter for your call? 
FORCE Information

If you click Submit, and it stays on this screen, scroll up to make sure that you answered all questions that say "This field is required." and that there are no other error messages in red.