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FSGS Patient Survey

The National Kidney Foundation and NephCure Kidney International will hold an Externally Led Patient-focused Drug Development Meeting on Focal Segmental Glomerulosclerosis (FSGS).

Please complete the survey below so your input can be used to plan this meeting.

THIS SURVEY IS FOR FSGS PATIENTS AND THEIR PARENTS AND CARE-PARTNERS

PARENTS AND CARE-PARTNERS: If necessary, please help your child or patient to complete the survey.
 
Your responses to the survey questions will be kept strictly confidential.

IMPORTANT: To exit the survey and then return later to finish:
1. Go to the bottom of the page on which you are working and select “Next”
2. Select “Exit” (upper right) and your work will be saved automatically.

TERMS: FSGS = focal segmental glomerulosclerosis
13%
1.First Name(Required.)
2.Last Name(Required.)
3.Email Address (We may need to contact you about the meeting).(Required.)
4.Phone Number (We may need to contact you about the meeting).
5.Age(Required.)
6.I identify as:(Required.)
7.Occupation
8.City and state in which you live (if you're in college, please list home and college city and state)(Required.)
9.I am an:(Required.)
10.Ethnicity/Race (Choose all that apply):