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Chordoma Questionnaire
Patients name _______________________________________________
Contact information:
Address__________________________________________________________________________________________________________________________
E-mail ________________________________________________
Phone ________________________________________________
1. What was the symptom (Headache, neck pain, difficulty swallowing, etc...) that initially brought you to the doctor for this condition?
________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2. a. When did you first see a doctor for the symptoms caused by the tumor?
________________________________________________________________
b. How long had you had symptoms before going to the Doctor?
________________________________________________________________
3. Did your doctor recommend further testing at your first visit ( CT, MRI, etc...), and if he/she did what studies were done?
________________________________________________________________________________________________________________________________________________________________________________________________
4. What was your doctor's first explanation for your initial symptoms? ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
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