Symptom Assessment Tools Order Form

Our symptom assessment tools are copyrighted and validated intellectual property and may not be altered in any way or translated into another language. Contact us if a language or version you need is not offered.

Department of Symptom Research
Attn: Assessment Tools
The University of Texas MD Anderson Cancer Center
1515 Holcombe Boulevard, Unit 1450
Houston, Texas 77030
symptomresearch@mdanderson.org

Licensing fees and a $200 processing fee may apply. Fees will vary depending on the type and extent of use, the setting, and who is sponsoring the research (either in full or in part).

A License Agreement that includes certain terms and conditions is required for your order to be processed. After you complete this order form, if the requested use of the tool(s) is appropriate, a License Agreement specific to this use will be sent to your organization via the contact information you provide. The tool(s) will be sent to you, along with an invoice for the appropriate license fee, once the License Agreement has been finalized.

MD Anderson employees: Processing and licensing fees are waived for use of the tools in clinical practice at MD Anderson and in studies for which an MD Anderson faculty member is the principal investigator (waiver does not apply to MD Anderson site co-investigators on multi-site studies). Please ignore any waived fees added during the ordering process.

If you are an MD Anderson employee, please enter your MD Anderson employee ID:

Intended Use:

Student research (thesis, dissertation)
Reproduction in educational materials (e.g., article, book chapter, lecture, presentation)
Clinical practice
Hospital or other institution
Non-funded academic research study
Funded academic research study
Commercial/pharmaceutical research study