Sign up below to participate.

Please note answers to the True Cost of FSHD Survey are completely anonymous and de-identified.

First Name *

Last Name *

Email *

Address *

City *

State *

Zip *

Country * United States

I would like to participate in the True Cost of FSHD study * Yes

Are you a patient with FSHD? * YesNo

I am a... (check all that apply) Relative of a PatientCarePartnerPhysicianResearcherPhysical TherapistOther Clinician

Comments