Request for Additional Information Questionnaire

Alport Syndrome Foundation is partnering with the National Kidney Foundation to create a new patient registry for Alport syndrome patients: NFK Patient Network – Alport Syndrome.  

By completing the following questions, you will receive direct email communication with updates and an invitation to join the new NKF Patient Network - Alport Syndrome Patient Registry (expected to formally launch in November 2021). Participation in patient registries helps drive research and clinical trials. We appreciate your interest. 

Completing these questions only means you will receive email information about this new registry, it does not commit you to participating or joining.

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* 1. Please provide your first and last name.

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* 2. Please provide the best email address to reach you.

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* 3. I consent to receiving email communication with updates and an invitation to join the new NKF Patient Network - Alport Syndrome patient registry, and acknowledge that my email address will not be used for any other marketing/communications purposes.

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