YANA - YOU ARE NOT ALONE NOW

PROSTATE CANCER SUPPORT SITE

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JOIN US - PUT YOUR STORY ON YANA

Please join us. If you page down to the form below, complete it and send it in, we will post your story to the site.

 

IMPORTANT: Material posted on the Internet is freely accessible to others through Search Engines. It is becoming a frequent practice to 'google' for personal information and you should be aware of this when posting. If this is of concern, you may wish to conceal your name by using a pseudonym or using an initial for your last name instead of your full name. If you do use a pseudonym, please use your imagination - we don't want a dozen John Does or Joe Bloggs on the site! Please mail Terry if you wish to change your name.

If you have already filled in this form but want to update your story,
PLEASE GO HERE FOR THE UPDATE FORM

JOIN US Filling out the form below will send the information directly to Yana's Prostate Cancer Support Group WebMaster. You may find it easy to use your TAB key to move through the fields. You should receive a reply from us within 48 hours. Thank you for joining us - remember:

What is your surname?	Please enter your State & Country where you live.
What is your first name?	Do you wish to be a Mentor for YANA? (This means will you be available by email to help others with your knowledge & experience) Yes     No
What is your wife's/partner's name?	Do you agree to have your story placed on YANA? (So that others may benefit from your experience?) Yes     No
**Please type your email address. ** (Required Field - For this form to work, we need your email address, thanks)	Thank you! Would you now please fill in your Profile below.

What was your age at time of diagnosis?	Date of your initial diagnosis?
What was your PSA Count at the initial diagnosis?	Gleason Grading at initial diagnosis?
What Treatment did you choose? (Type "undecided" if this is so)	Staging at initial diagnosis? Thank you! Would you now please fill in your STORY below.

Please tell us of your experiences on the form below. Thank you for completing this form. Thank you for sharing your story. Please continue here. Thank you! Would you now please click on "Send"... (After Sending this form to YANA, you will be taken back to YANA's Home Page)