Scope Sounding Board, NCBI Members

We are so thrilled that you are interested in learning more about or even joining our Scope Sounding Board. We hope that we can achieve the extraordinary by bringing patients together to have their voices heard, learn from their lived experiences and offer disease specific supports where needed.

Please share your details below and Amie will be in touch with you shortly. You must be 18 or older to join the Scope Sounding Board.

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* 1. Please share your contact here

Name

Country

Email Address

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* 2. A little more information

Age

Gender

Are you a parent

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* 3. Please tick the most relevant box, you can tick multiple boxes if you fall into more than one category

Dry Eye Disease or I use eye drops regularly

Glaucoma

Diabetic Retinopathy

Use Prosthetics

Sjogren's Symdrome

Blepharitis

Immune Deficiencies

IBS

Migraine

Dermatitis

Eczema

Dry AMD (Age Related Macular Degeneration)

Parent

A Parent of someone who is living with one or more of the conditions listed above

Scope Sounding Board, NCBI Members

Question Title

* 1. Please share your contact here

Question Title

* 2. A little more information

Question Title

* 3. Please tick the most relevant box, you can tick multiple boxes if you fall into more than one category

Question Title

* 4. Please leave any additional comments below