Response

If you have taken or are currently taking Xtandi and would like to share your story with my office, please fill out the information below:

Prefix

* First Name

* Last Name

* City

* State

* Zip

* Email

* Primary Phone

* Do you currently take Xtandi?

Yes
No

* Are you willing to share your name and story publicly?

Yes
No

* Please share your story, including how much you currently pay for Xtandi: