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Thank you for your interest in learning more about our Patient Advisory Committee. Please complete the form below and we will contact you with more information.

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* 1. General Contact Information

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* 2. In what year were you born? (enter 4-digit birth year; for example, 1976)

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* 3. How did you hear about CSRF?

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* 4. Date of diagnosis? (if applicable)

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* 5. Are you interested in sharing your Cushing's story on our website or in a future issue of our Newsletter?

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* 6. What areas would you like to participate in the Patient Advisory Committee? (You may select more than one)

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* 7. Comments or feedback

When you submit your form, expect a response within a few business days. Thank you!
Contact gretchen@csrf.net for questions or more information. 
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