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Prostate Cancer Center of Seattle New Patient Questionnaire Name: ___Today's date: ___MEDICAL HISTORY Previous cancer High blood pressure Heart attack Pacemaker/N Y/N Y/N Y/Stroke Emphysema/COPD Diabetes

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Prostate cancer center focuses on research, treatment, and support services for individuals with prostate cancer.

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Medical professionals, researchers, and organizations involved in the care and study of prostate cancer are required to file.

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The purpose of prostate cancer center is to gather information, track cases, and improve the overall understanding and treatment of prostate cancer.

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Information such as patient demographics, diagnosis, treatment history, and outcomes must be reported on prostate cancer center forms.

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