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Are you 18 years of age or older? * Please select one... Yes No

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Postal Code *

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Are you Male or Female? Please select one... Male Female Prefer not to say

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Have you been diagnosed with myelofibrosis? * Please select one... Yes – I have myelofibrosis No

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Have you been told by a doctor that you have an enlarged spleen? * Please select one… Yes No I don’t know

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Have you previously received treatment for your myelofibrosis? * Please select one... Yes No I don't know

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