COC Enrollment and Payment

Do you live in the United States or Canada?
- Yes
- No
If based outside US & Canada, Click here
How did you hear about us?
Are you currently doing standard of care treatments (i.e. chemo, radiation) or have you done so in the past?
- Yes
- No
Your details need to be discussed with a patient coordinator. Please reserve a call.

Initial eligibility check: please select an option from 1-5 which best describes the patient's current status:*
- 1. Fully active, able to carry on all pre-disease activities without restriction
- 2. Restricted in physically strenuous activity, but mobile and able to carry out work of a light or sedentary nature, e.g. light housework, office work
- 3. Mobile and capable of all selfcare but unable to carry out any work activities; up and about more than 50% of waking hours.
- 4. Capable of only limited selfcare; confined to bed or chair more than 50% of waking hours
- 5. Completely disabled/immobile; unable to carry on any selfcare; totally confined to bed or chair
Your details need to be discussed with a patient coordinator. Please reserve a call.