We consider this community as experts on DRESS Syndrome, due to their first-hand experience. Patients are their own best advocates. And patient groups are more than voices — through their experiences, they can drive change and expedite research. As such, they have unique insights that can help inform the decisions we make, the services we provide, and the connections we create. Please note: We reserve the right to choose whether to accept any person who contacts us to become a member of our Patient and Family Advisory Panel.

*1.Are you a DRESS Syndrome patient or loved one of a patient?(Required.)

DRESS Syndrome patient

Loved one of a DRESS Syndrome patient

*2.First and Last Name(Required.)

3.If you're a loved one of a DRESS patient, what age are they?

*4.Are you or your loved one past the critical stages of having DRESS Syndrome? (Being past the initial reaction stage is important because you’ll have gained perspective on navigating the illness.)(Required.)

Yes

No

*5.What country do you live in?(Required.)

6.If outside of the U.S., are you interested in serving as an International Representative for your region?

Yes

No

*7.Briefly describe your experience with DRESS Syndrome, such as: medicine that caused the reaction, symptoms, diagnosis and treatment, and recovery.(Required.)

*8.Why does serving on the Patient and Family Advisory Panel interest you?(Required.)

*9.Provide any education, career, or other personal details you wish you to share. (This info is for the Panel bio.)(Required.)

*10.Share your preferred email address and phone number.(Required.)

*11.Please submit a photo or headshot we can use with your Panel bio.(Required.)

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