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* previously known as Non alcoholic steatohepatitis (NASH)
** Early breast cancer: Confined to the breast with/without lymph node involvement and the absence of distant metastatic disease

Are you interested in joining the
Patient Partnership Program?

..

We have a few more questions that will help us understand more about your experience.

..

Please provide us with a few more details about yourself.

Sex and Ethnicity

(The following questions are optional)

Note: Follow-up interviews may be conducted by phone, by email, or through a virtual meeting tool.

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with bladder cancer. 

Z4-74694

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience as a caregiver of a person with bladder cancer.

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with heart failure.

Z4-75026

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience as a caregiver of a person with heart failure. 

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with chronic kidney disease (CKD). 

Z4-74848

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a caregiver of a person with Chronic Kidney Disease. 

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with asthma.

Z4-74828

Thank you for your interest in the Patient Partnership Program.

Z4-74830

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with lung cancer. 

Z4-74699

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with lung cancer. 

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with metastatic breast cancer. 

Z4-74822

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with metastatic breast cancer.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with ovarian cancer.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with ovarian cancer. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with Type 2 Diabetes. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with Type 2 Diabetes. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a person with Neurofibromatosis Type 1. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you. 

Next we will ask you a few questions about your experience as a caregiver of a person living with Neurofibromatosis Type 1 (NF1).

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with early breast cancer. 

Z4-74687

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with early breast cancer. Early breast cancer is defined as confined to the breast with /without lymph node involvement and the absence of distant metastatic disease

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with lupus erythematosus (LE), also known as lupus, including cutaneous lupus erythematosus (CLE), systemic lupus erythematosus (SLE), and lupus nephritis (LN). Please answer according to your experience.

Z4-81627

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with Systemic Lupus Erythematosus (SLE). 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a person with Eosinophilic gastrointestinal disorder.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with Eosinophilic gastrointestinal disorder.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a person with Non Alcoholic Steatohepatitis (NASH).

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a caregiver of a person with Non Alcoholic Steatohepatitis (NASH).

Please answer following questions for the main person you care for.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with Eosinophilic esophagitis.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next we will ask you a few questions about your experience and perspectives as a person with Eosinophilic esophagitis.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with cholangiocarcinoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with cholangiocarcinoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with liver cancer (hepatocellular carcinoma).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with hepatocellular carcinoma (liver cancer).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with ampullary cancer (Ampulla of Vater cancer). 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as caregiver of a person with Ampulla of Vater cancer, also referred to as liver cancer or biliary duct cancer. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with gall bladder cancer, also referred to as liver cancer or biliary duct cancer.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as caregiver of a person with gall bladder cancer, also referred to as liver cancer or biliary duct cancer. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable. 

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with Chronic obstructive pulmonary disease (COPD).

Z4-74832

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a caregiver of a person with COPD 

Z4-74833

Thank you for your interest in the Patient Partnership Program.. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with Hyperkalemia (high potassium). 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person with Hyperkalemia

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with prostate cancer.

Z4-74678

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with prostate cancer. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience as a caregiver of a person who is taking blood thinners or factor Xa inhibitors. 

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with chronic lymphocytic leukaemia (CLL). 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with chronic lymphocytic leukaemia (CLL). The text will appear here

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with a diffuse large B-cell lymphoma (DLBCL). 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with diffuse large B-cell lymphoma (DLBCL).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with mantle cell lymphoma (MCL). 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with Mantle cell lymphoma (MCL).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with small lymphocytic lymphoma (SLL)

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with small lymphocytic lymphoma (SLL).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience as a caregiver of a person with Amyloidosis.

Z4-75068

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person living with Amyloidosis. 

Z4-75051

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with follicular lymphoma. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with follicular lymphoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with indolent non-Hodgkin's lymphoma. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with indolent non-Hodgkin's lymphoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with skin (cutaneous) B-cell lymphoma. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with skin (cutaneous) B-cell lymphoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with lymphoplasmacytic lymphoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with lymphoplasmacytic lymphoma.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with acute myeloid leukaemia (AML)

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with acute myeloid leukaemia (AML).

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with marginal zone lymphomas. 

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program. We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with marginal zone lymphomas.

The next question is for demographical purposes only, it is not compulsory to answer if you do not feel comfortable.

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience as a carer of a person with endometrial cancer.

Z4-74961 2 July 2025

Thank you for your interest in the Patient Partnership Program.  We would like to know a little more about you.

Next, we will ask you a few questions about your experience and perspectives as a person with endometrial cancer.  

Z4-74810 2 July 2025

Thank you for your interest in the Patient Partnership Program. 

Next, we will ask you a few questions about your experience and perspectives as a caregiver of a person living as overweight or with obesity. In this survey, overweight is defined as a body mass index (BMI) of >25 and <30 kg/m² and obesity as >30 kg/m².

Z4-77729 29 September 2025    

Thank you for your interest in the Patient Partnership Program. 

Next, we will ask you a few questions about your experience and perspectives as a person living as overweight or with obesity. In this survey, overweight is defined as a body mass index (BMI) of >25 and <30 kg/m² and obesity as >30 kg/m².

Z4-77726 29 September 2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as someone who cares for a person with gastric cancer.

Z4-75681 9 July 2025

Thank you for your interest in the Patient Partnership Program. 

Next, we will ask you a few questions about your experience and perspectives as a person with gastric cancer.  

Z4-74789 2 July 2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with dyslipidaemia (hyperlipidemia / high cholesterol).

Z4-75078 28-July-2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience as a caregiver of a person with dyslipidaemia (hyperlipidemia / high cholesterol).

Z4-75079 01-Aug-2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with hypertension (high blood pressure). 

Z4-75075 28-July-2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a caregiver of a person with hypertension (high blood pressure).

Z4-75076 01-Aug-2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience and perspectives as a person with Systemic Sclerosis (SSc), also known as Scleroderma.

Z4-76361 11-Aug-2025

Thank you for your interest in the Patient Partnership Program.

Next, we will ask you a few questions about your experience as a carer of a person with Systemic Sclerosis (SSc), also known as Scleroderma. 

Z4-76363 11-Aug-2025

Thank you for your interest in the Patient Partnership Program. 

Next, we will ask you a few questions about your experience and perspectives as a person living with idiopathic pulmonary fibrosis (IPF).

Z4-75071

Thank you for your interest in the Patient Partnership Program. 

Next, we will ask you a few questions about your experience as a carer of a person with idiopathic pulmonary fibrosis (IPF). 

Z4-75072

Privacy Notice and Consent Authorisation

AstraZeneca UK Limited, a company incorporated in England under no. 03674842 whose registered office is at 1 Francis Crick Avenue, Cambridge Biomedical Campus,  Cambridge, CB2 0AA, England, want to collect some personal information from you, such as your name and contact details and some health information, in an effort to learn more about you, your health experiences, and any educational, work or life skills that may be relevant to your participation in AstraZeneca’s Patient Partnership Program as described on this website.

 

Your personal information will be stored in a secure server and kept for a period of three years and then deleted unless you have a signed Master Service Agreement (MSA) with AstraZeneca’s Patient Partnership Program. References to AstraZeneca throughout the platform will mean AstraZeneca UK and any of its Affiliates around the world. Your personal information may be shared with: other AstraZeneca affiliates and third party agents involved in the Patient Partnership Program or IT providers for the purposes of conducting programs in their countries as well as for system development and technical support; trusted partners who help us with the organization and conducting of our meetings/events, including virtual meetings/events. Such AstraZeneca affiliates and agents may be based outside your country of residence and in countries that do not offer the same level of protection as yours (including outside the European Union for EU residents and outside of Canada and the province of Quebec) . Please find out more information about how AstraZeneca protects your data at https://www.globalprivacy.astrazeneca.com/ .

 

AstraZeneca may contact you by email, virtual meeting platform or phone in order to better understand your interests, background and eligibility pertinent to this program. With your consent, such conversations may be recorded using voice recording equipment. The Patient Partnership Program and other AstraZeneca activities are entirely optional. You do not have to participate in this program, and not participating will not affect your right to obtain medications. To find out more about the program – contact PPP@astrazeneca.com.  To exercise your privacy rights, such as withdrawing your consent or correcting your information, please contact privacy@astrazeneca.com.