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    Your Name *

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    Where do you live?

    How old are you now?

    How old were you when diagnosed?

    Please take a few sentences to tell us your story.

    Is there a history of Colon Cancer in your family?

    What treatment facilities or hospitals have you used?

    What's the most important thing that has helped you fight colon cancer?

    What do you think others can learn from your experience?

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