Welcome to Untire

Thanks for your interest in Untire. Please fill out the following questions below. Your insights will allow us to improve access to Untire for patients and survivors throughout the world.

We will send an email with further information and instructions on obtaining access to Untire after completing this questionnaire.

Name*

Email address*

Cancer type*

Year of diagnosis*

Name of your oncologist(s)*

Hospital*

Location*

Please select one of the following:

Please fill out the following questions

  1. How did you find out about Untire?


  2. Do you consider yourself fatigued?

  3. Other:

  4. Please rate the level of your fatigue on the scale from 0 (no fatigue) to 10 (severe fatigue)

  5. Please rate the level of your energy on the scale from 0 (no energy) to 10 (highest energy)

  6. How long have you experienced fatigue?

  7. Have you discussed your fatigue with your care provider?

  8. What do you currently use to help you with your fatigue? (Select all that apply.)

  9. Other:

  10. How has your fatigue impacted you? (Select all that apply.)

  11. Other:

  12. Do you currently use any digital health or wellness apps?

  13. If yes, please list:

Click here to expand the full information and consent letter.