Patient Navigator Request Form
FSR is pleased to provide one-on-one support to sarcoidosis warriors and/or their caregivers through our Patient Navigator Program. FSR takes great care in pairing new or first-time-flair sarcoidosis warriors with a Patient Navigator who best fits your lifestyle and type of sarcoidosis.
This application may take 15-45 minutes to complete. Please sets aside the time you need to fill it out completely. You may save your progress and return to the application at anytime until it has been submitted.
We understand some of the questions in this application will feel very personal. FSR takes your privacy and confidentiality seriously. While some questions are optional, others are not. This is a pilot program and we are trying to ensure it works for you and your Patient Navigator. Therefore, It is important to answer the questions to the best of your ability.