[fusion_builder_container type=”flex” hundred_percent=”no” equal_height_columns=”no” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” background_position=”center center” background_repeat=”no-repeat” fade=”no” background_parallax=”none” parallax_speed=”0.3″ video_aspect_ratio=”16:9″ video_loop=”yes” video_mute=”yes” border_style=”solid”][fusion_builder_row][fusion_builder_column type=”1_1″ type=”1_1″ background_position=”left top” border_style=”solid” border_position=”all” spacing=”yes” background_repeat=”no-repeat” margin_top=”0px” margin_bottom=”0px” animation_speed=”0.3″ animation_direction=”left” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” center_content=”no” last=”no” hover_type=”none” min_height=”” link=””][fusion_text animation_direction=”left” animation_speed=”0.3″ animation_delay=”0″ hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky”]

European Map form

Please fill out this form if you would like your country and/or LTFU care center to be represented on the PanCare European Map of LTFU care.

[/fusion_text][fusion_imageframe aspect_ratio=”” custom_aspect_ratio=”100″ aspect_ratio_position=”” lightbox=”no” linktarget=”_self” align_medium=”none” align_small=”none” align=”none” mask=”” custom_mask=”” mask_size=”” mask_custom_size=”” mask_position=”” mask_custom_position=”” mask_repeat=”” style_type=”” hover_type=”none” magnify_duration=”120″ scroll_height=”100″ scroll_speed=”1″ margin_medium=”” margin_small=”” caption_style=”off” caption_align_medium=”none” caption_align_small=”none” caption_align=”none” caption_title_tag=”2″ animation_direction=”left” animation_color=”” animation_speed=”0.3″ animation_delay=”0″ hide_on_mobile=”small-visibility,medium-visibility,large-visibility” sticky_display=”normal,sticky” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ max_width=”1250″ image_id=”13721|full”]https://pancaresurfup.eu/wp-content/uploads/2025/04/European-map-banner-1.png[/fusion_imageframe][fusion_text]

Consent
How are the LTFU care clinic(s) in your country organized?
Does the start of LTFU care depend on the end date of diagnosis or end date of treatment?
For what period is LTFU care provided to survivors?
At what frequency are follow-up care consultations provided to a survivor?
Which facilities are available to carry out LTFU-care?
Please consider the facilities that are available within LTFU care service, within the hospital/institution the LTFU-Care clinic belongs to and in another hospital/institution.
What does the provided LTFU care entail?
Is there a dedicated healthcare professional who directs the LTFU care of survivors and if so what does this person do?
Who finances the LTFU care e.g. how are the costs of visits and performed tests covered?
What is the provided LTFU care based upon?
Does your follow-up care service facilitate peer-to-peer support from other CAYA cancer survivors?
Does your follow-up care service facilitate contact with relevant patient organisations for survivors?

[/fusion_text][/fusion_builder_column][/fusion_builder_row][/fusion_builder_container]