Assessment Step 1 of 12 8% * I have read and agree to the privacy policy. Who is completing this questionnaire?*Medical ProfessionalParent/GuardianSurvivorSocial WorkerOther Patient or Entry NameYou may enter the patient's name or some other name/title that will help you distinguish the results of this questionnaire from any others you may complete. This will be printed on the results page. Gender* Male Female Year of birth*(This is the year of birth of the person whom the assessment is for.)Select a Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923Age (in full years at diagnosis)*If child was diagnosed at less than a year old, enter 1Please enter a number from 1 to 110.Year of diagnosis*Select a Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923 How would you like to find your possible late effects?* I would like to input information about my cancer diagnosis and treatment in order to receive a late effects assessment specific to me. I do not have specific information on my treatment and would like to receive an assessment based on medical concerns that I am experiencing Diagnosis* Leukemia Lymphoma Solid Tumors Diagnosis Options Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Chemotherapy Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Other Chemotherapy (Please do NOT check chemotherapies related to transplant.)Chemotherapy related to bone marrow transplant will be addressed later in the assessment. Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Treatment Options Bone Marrow Transplant Radiation Surgery Chemotherapy for Bone Marrow TransplantIf you had chemotherapy for your bone marrow transplant, select all that apply below. BCNU (Carmastine, BiCNU) - in association with Bone Marrow Transplant Busulfan (Myleran, Busulfex) - in association with Bone Marrow Transplant Carboplatin (Paraplatin, CBDCA) - in association with Bone Marrow Transplant Cisplatin (Platinol-A, Cis-diammine dichloroplatnium, Cisplatinum) - in association with Bone Marrow Transplant Cyclophosphamide (Cytoxan, Cytophosphane) - in association with Bone Marrow Transplant Etoposide (Eposin, Etopophos, Vepesid, VP-16) - in association with Bone Marrow Transplant Fludarbine - in association with Bone Marrow Transplant Melphalan (L-Pherylalanine Mustard, L-PAM, L-Sarcolysin, Alkeran, Melphalanhydrochloride) - in association with Bone Marrow Transplant Prednisone (Daltasone, Meticorten, Liquid Pred, Orapred, Prednisolone) - in association with Bone Marrow Transplant Thiotepa (Tepa, Tspa, ThioTEPA) - in association with Bone Marrow Transplant Areas of Radiation Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Areas of Surgery Abdomen Arms/Legs Chest Head/Neck Neurosurgery Pelvic Types of Surgery in the Abdominal Area Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Types of Surgery in the Limbs Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Types of Surgery to the Chest Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Types of Surgery to the Head and Neck Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Types of Neurosurgery Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Types of Surgery to the Pelvic Area Dummy 1 Dummy 2 Dummy 3 Dummy 4 Dummy 5 Dummy 6 Dummy 7 Dummy 8 Dummy 9 Dummy 10 Dummy 11 Dummy 12 Dummy 13 Dummy 14 Dummy 15 Dummy 16 Dummy 17 Dummy 18 Dummy 19 Dummy 20 Dummy 21 Dummy 22 Dummy 23 Dummy 24 Dummy 25 Dummy 26 Dummy 27 Dummy 28 Dummy 29 Dummy 30 Dummy 31 Dummy 32 Dummy 33 Dummy 34 Dummy 35 Dummy 36 Dummy 37 Dummy 38 Dummy 39 Dummy 40 Dummy 41 Dummy 42 Dummy 43 Dummy 44 Dummy 45 Dummy 46 Dummy 47 Dummy 48 Dummy 49 Dummy 50 Dummy 51 Dummy 52 Dummy 53 Dummy 54 Dummy 55 Dummy 56 Dummy 57 Dummy 58 Dummy 59 Dummy 60 Dummy 61 Dummy 62 Dummy 63 Dummy 64 Dummy 65 Dummy 66 Dummy 67 Dummy 68 Dummy 69 Dummy 70 Dummy 71 Dummy 72 Dummy 73 Dummy 74 Dummy 75 Dummy 76 Dummy 77 Dummy 78 Dummy 79 Dummy 80 Dummy 81 Dummy 82 Dummy 83 Dummy 84 Dummy 85 Dummy 86 Dummy 87 Dummy 88 Dummy 89 Dummy 90 Dummy 91 Dummy 92 Dummy 93 Dummy 94 Dummy 95 Dummy 96 Dummy 97 Dummy 98 Dummy 99 Dummy 100 Dummy 101 Dummy 102 Dummy 103 Dummy 104 Dummy 105 Dummy 106 Dummy 107 Dummy 108 Dummy 109 Dummy 110 Dummy 111 Dummy 112 Dummy 113 Dummy 114 Dummy 115 Dummy 116 Dummy 117 Dummy 118 Dummy 119 Dummy 120 Dummy 121 Dummy 122 Dummy 123 Dummy 124 Known Medical Issues Arthritis Breast Hypoplasia Chronic Pain Decreased Heart Function Delayed Puberty Dental Caries Early Menopause Fatigue Fragile Bones Graft Versus Host Disease Hair Loss Hearing Loss Hormone Deficiency - Antidiuretic Hormone Deficiency - Cortisol Hormone Deficiency - Growth Hormone Hormone Deficiency - Testosterone Hormone Deficiency - Thyroid Infertility Learning Issues Loss of Libido Peripheral neuropathy Scoliosis Second Cancer Short Stature Vision Problems Areas of Graft Versus Host Disease Eyes Gastrointestinal Hair Immune system Liver Mouth Musculoskeletal Nails Respiratory Skin Spleen Vaginal Fibrosis I would like to learn more about Long-Term Follow-Up Clinics Select your state to learn about long-term follow-up clinics in your areaAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Security CodeCommentsThis field is for validation purposes and should be left unchanged.