PharmASSIST — NSCLC Decision Support

🫁 Lung Cancer · NSCLC

Help your care team give you
the best possible cancer treatment

This survey helps start the conversation with your care team about your diagnosis, your testing, and your treatment preferences.

~40%

of lung cancer patients don't get recommended testing

5 min

to complete these questions

Print or share your summary with your care team at your next appointment.

Decision Support. Better Care.

Your Diagnosis

Question 1 of 6

What type of lung cancer were you told you have?

Non-small cell lung cancer (NSCLC)

Includes adenocarcinoma, squamous cell, large cell

Small cell lung cancer (SCLC)

I'm not sure

Question 2 of 6

Has your cancer spread beyond the lung?

Yes — it has spread to other parts of my body

Your doctor may have called this metastatic or stage IV

No — it appears to be in the lung only

I'm not sure

Question 3 of 6

Have you started treatment yet?

No — I have not started treatment

Yes — I have started treatment

I had surgery but no other treatment yet

I'm not sure

Question 4 of 6

Has your tumor been tested for biomarkers or genetic changes?

Sometimes called molecular tests, NGS, or tumor profiling. These tests look for specific changes in your tumor that can guide which treatment works best.

Yes — testing has been completed

Yes — it was ordered and I am waiting for results

No — I don't think this was ordered

I'm not sure

Question 6 of 6

Do you have your biomarker test results available?

In a patient portal, letter, or printout.

Yes

Question 6 of 14

Is there someone who helps you make important medical decisions?

Yes — a family member or partner

Yes — a caregiver or healthcare proxy

No — I make decisions on my own

I'd like help identifying someone

Question 7 of 14

Do you have someone who can help you with appointments, medications, or daily activities during treatment?

Yes — I have reliable support

Sometimes — support is limited or not always available

No — I will be managing mostly on my own

Your Results

Question 8 of 13

Did your doctor tell you whether any mutations or changes were found in your tumor?

Yes — something was found

No — nothing was found

Results were unclear or incomplete

I haven't discussed results with my doctor yet

Question 9 of 13

Do you know the name of what was found?

It is completely okay if you don't know.

EGFR

ALK

KRAS G12C

ROS1, RET, MET, or NTRK

PD-L1 only — no other mutation found

Something was found but I don't know the name

Not sure

Your Preferences

Question 11 of 13

Did your doctor tell you the specific type of mutation or change?

Common EGFR mutation

Your doctor may have said exon 19, exon 21, or L858R

Exon 20 insertion

A different or uncommon type

I know it's EGFR but don't know the type

I'm not sure

Question 12 of 13

Has the cancer spread to your brain or spine?

Yes

I'm not sure

Question 13 of 13

What matters most to you in your treatment?

Select one response for each statement. Your answers go directly to your care team.

Key: SA = Strongly agree A = Agree N = Neutral D = Disagree SD = Strongly disagree

SA A N D SD

Is there anything else you'd like your care team to know?

Optional — your words will appear directly in your summary.

Final question

Has your doctor talked with you about what treatment they are recommending?

Yes — we have a treatment plan

We talked but I didn't fully understand

Not yet

Would you like more time to talk with your care team before making a decision?

Yes — I'd like more time first

No — I feel ready

🩺 Clinician Summary — PharmASSIST

PharmASSIST — Patient-Reported Summary

Patient Overview

Treatment Preferences

| This summary is based solely on patient-reported responses and has not been verified against clinical records. It is intended for informational and decision-support purposes only. It does not constitute medical advice, a clinical diagnosis, or a treatment recommendation, and does not replace the professional judgment of a licensed healthcare provider. © 2026 PharmASSIST. All rights reserved.

For educational and decision-support purposes only. Does not replace clinical judgment.
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