ECTODERMAL DYSPLASIA – TYPE UNKNOWN RESEARCH STUDY

Participation is limited to the first 50 eligible families. A member of the NFED staff will follow-up with you regarding your responses.

Question Title

* 1. Have you or a member of your family had genetic testing?

Yes

No

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* 2. Has the individual received a molecular diagnosis? Meaning: did genetic testing identify the gene associated with ectodermal dysplasia?

Yes

No

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* 3. Does the biological mother agree to provide a blood sample for this Study?

Yes

No

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* 4. Does the biological father agree to provide a blood sample for this Study?

Yes

No

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* 5. Will you allow your child affected by ectodermal dysplasia to provide a blood sample for this Study?

Yes

No

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* 6. Please provide your contact information for follow-up.

Name

City/Town

State/Province

Email Address

Phone Number