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Step 1: Provide the study team with the email address of the department representative

Email contact information for the department representative who will be gathering the information and completing the online data collection forms to the study team at [email protected].

Once the team has received an email address for your department, that person will receive an email with the subject line: **STUDY INVITATION** FOR THE NORTHWELL HEALTH FIREFIGHTER CANCER STUDY.

The email will contain instructions for completing the forms and the link to access them.

Step 2: Open the link and complete the online data collection forms

Be sure to fill out the following:

  • Department information
    • Answer the questions with general information about the fire department.
    • Fill out the department representative’s contact information.
  • Personnel information files
    • Option 1: Use your own computer program to make a list of the required personnel information for all past (inactive, exempt and deceased) and present members and upload the file in the online data collection forms.
    • Option 2: Download the Excel spreadsheet created by the study team and enter the required information for all past (inactive, exempt and deceased) and present members of your department, and upload the file with the online data collection forms.
    • Option 3: Mail in or fax your forms. If you select this option, please contact Gina Arena at (516) 465-1944 or [email protected] for further instructions before sending any information.

Please send information for all past and present members of your department, not just those with cancer. We do not need to know any medical information about any members, just the following:

  • Complete name (last, first, middle initial)
  • Date of birth
  • Current street address, town or city, state, ZIP code
  • Sex and ethnicity/race
  • Status (active, inactive, exempt or deceased) and rank at fire department
  • Date joined, date exempt/resigned and any gaps in service

Complete as much information for each firefighter as available; anything unavailable can be left blank.

Ready to participate?

Complete step 1 by clicking here to email the study team your department representative’s contact information.