SC Lupus Registry Survey
Tell us what you know about Lupus in South Carolina. These findings may lead to identifying how many South Carolinians have Lupus.   The development of a lupus registry will provide ongoing access for researchers on the impact of SLE on communities in South Carolina. The registry database will also:

- Help determine how many people and their families are afflicted with Lupus in South Carolina.
- Help determine how many new cases occur each year.
- Help provide an ongoing process in which the medical community can better engage patients.

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Zip Code *
Which of the following statements best describes you? *
Required
How often does someone you know diagnosed with Lupus visit the emergency room in 3 months time? *
Required
*
YES
NO
N/A
I know what type of Lupus that I or someone else has.
I or someone I know was diagnosed with Lupus before the year 2000.
I know if someone has Lupus when I see him or her.
I know a medical facility that treats Lupus patients.
Lupus can affect children.
Lupus is more prevalent in older (45-65) people.
You have no quality of life if you are diagnosed with Lupus.
Someone with Lupus cannot work at all.
A physician must diagnose someone with Lupus.
Please use this area to ask any questions.
Please use this area to state any comments or concerns.
Contact Information
*Optional. The completion of this area is optional. Please complete this area if you would like more information sent to you about Lupus in South Carolina.
First and Last Name
Mailing Address
Thank you!
 [The Development of a South Carolina Lupus Registry is being completed in accordance with the University of South Carolina, Institute for Partnership to Eliminate Health Disparities (IPEHD)]
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