Gaucher disease (MR)

We are a branch of a larger market research company, whose goal is to make contact with as many people diagnosed with "Gaucher" disease. We will be looking to reach out to those who show interest in the form of online surveys and telephone discussions to understand the needs of diagnosed patients. When contacted and qualified we will pay respondents for their time (up to $100).

All information collected during the surveys or phone discussions are completely confidential in that your name or other identifying information will not be shown to our clients.

Question Title

* 1. Please indicate if you are diagnosed patient or caregiver of diagnosed patient.

Diagnosed Patient

Caregiver

Other (please specify)

Question Title

* 2. Please indicate diagnosed "Type" of Gaucher disease?

Type I

Type II

Type III

Other (please specify)

Question Title

* 3. Please identify medications utilized, past or present.

Taliglucerase alfa (Elelyso™)

Velaglucerase alfa (VPRIV™)

Imiglucerase (Cerezyme™)

Other (please specify)

Question Title

* 4. Please provide basic demographic information.

Name, phone # is optional.

Name:

ZIP: *

Country:

Email Address: *

Phone Number:

Thank you very much for taking the time to fill out this short questionnaire. We are collecting basic information to match individuals with specific survey requirements in order to invite your participation.

Question Title

* 1. Please indicate if you are diagnosed patient or caregiver of diagnosed patient.

Question Title

* 2. Please indicate diagnosed "Type" of Gaucher disease?

Question Title

* 3. Please identify medications utilized, past or present.

Question Title

* 4. Please provide basic demographic information.Name, phone # is optional.

* 4. Please provide basic demographic information.

Name, phone # is optional.