Do you qualify?

To find out if you qualify for further evaluation, please answer the following nine questions. Your answers will remain strictly confidential and will not be recorded.

Have you received radiation therapy for head and neck cancer?*

Have you received radiation therapy for head and neck cancer?*

Have you had a cancer recurrence or any other cancer?*

Have you had a cancer recurrence or any other cancer?*

Has it been at least 3 years since you completed radiation therapy for head and neck cancer?*

Has it been at least 3 years since you completed radiation therapy for head and neck cancer?*

Do you have moderate or severe dry mouth due to radiation therapy for head and neck cancer?*

Do you have moderate or severe dry mouth due to radiation therapy for head and neck cancer?*

Are you at least 18 years of age?*

Are you at least 18 years of age?*

Are you interested in participating in a research study on dry mouth due to radiation therapy for head and neck cancer?*

Are you interested in participating in a research study on dry mouth due to radiation therapy for head and neck cancer?*

Have you ever been diagnosed with Sjogren’s syndrome?*

Have you ever been diagnosed with Sjogren’s syndrome?*

Do you live in the USA, Canada or the UK?*

Do you live in the USA, Canada or the UK?*

Do you currently use tobacco in any form (including vaping)?*

Do you currently use tobacco in any form (including vaping)?*

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