The goal of this project is to better understand what adolescent and young adult cancer patients (AYA) recall being told about their infertility risks associated with their cancer treatment, and how they decided to follow-up, or not, on referrals for clinical consultation related to reproductive health and fertility preservation. This study aims (1) to determine what adolescent and young adult patients understand and retain when engaged and informed about infertility risk and opportunities around the time of their diagnosis and prior to the initiation of therapy; and (2) to identify sociodemographic, clinical, and attitudinal factors that may be associated with AYA patients’ decisions to seek infertility risk information and counseling, with a particular focus on how and when they prefer to engage in reproductive health counseling and intervention. Findings of the study proposed here will describe how and why AYA patients decided to pursue clinical consultation related to fertility preservation, which will inform clinical practice around engagement and referral of patients and families. The findings also will inform development and testing of an age- and developmentally-appropriate decision-aid to help AYA patients and their families reconcile immediate needs related to cancer and its treatment and a future orientation to family planning and fertility preservation.