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Becoming a Member of the New York Proton Center Patient Alumni Network
It was our great pleasure to provide your proton therapy treatment. We would like to stay in touch and invite you to become a member of our Patient Alumni Network (the “Alumni Network”). The Alumni Network is open to anyone who received proton therapy at the New York Proton Center (“NYPC”).
As a member of the Alumni Network, you will receive the following benefits:
Be invited to free virtual and in-person social, educational, and wellness programs
Be sent periodic newsletters and updates (by e-mail and/or mail) with tips for healthy living and the latest news about NYPC and proton therapy
Receive occasional requests from NYPC to get your opinions on patient experience or alumni initiatives
Provide mentorship (at your option) to future NYPC patients
In addition to the benefits described above, NYPC may reach out to you if you check any boxes below indicating that you are interested in some or all of the following additional activities:
Are you willing to speak with or mentor other NYPC patients considering or beginning proton therapy for the same type of cancer?
Yes
No
Are you willing to have your proton therapy story shared on the NYPC website or social media channels?
Yes
No
Are you willing to join focus group discussions asking for patient opinions about NYPC initiatives?
Yes
No
To join the NYPC Alumni Network, please provide the following information:
First Name
Last Name
Address Line 1
Address Line 2
City
State
-- select an option --
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
NC
ND
NE
NH
NJ
NM
NV
NY
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VA
VT
WA
WI
WV
WY
Other
Zip
Country
Email
Phone
Radiation Oncologist
-- select an option --
Kaled Alektiar, MD
Richard Bakst, MD
Christopher Barker, MD
Oren Cahlon, MD
Arpit Chhabra, MD
J. Isabelle Choi, MD
Shaakir Hasan, MD
Madhur Garg, MD
Zahra Ghiassi-Nejad, MD, PhD
Daniel Gorovets, MD
Carla Hajj, MD
Robert Press, MD
Charles B. Simone II, MD
Rafi Kabarriti, MD
Stanislav Lazarev, MD
Nancy Lee, MD
Deborah Marshall, MD
Keyur Mehta, MD
Nitin Ohri, MD
Sonam Sharma, MD
Annemarie Shepherd, MD
Justin Tang, MD
Suzanne Wolden, MD
Josh Yamada, MD
Jonathan Tzu-I Yang, MD, PhD
By checking this box, I agree to become a member of the NYPC Patient Alumni Network and to the terms and conditions contained in the
NYPC Alumni Network Membership Terms, Conditions, and Privacy Practices
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