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Patient Feature Application
Please answer every question. For a blank answer just put NA. Thank You. If you have a full story to tell please email them to MCTDFoundation.shannon@gmail.com or secretary@mctdfoundation.org.
Name or Nickname you want to use *
Your answer
Where are you located ? (or) Where do you call home ? *
Your answer
When were you diagnosed ? How old were you ? *
Your answer
Your "care" team ( family, pets, supporters, anything that comforts you) *
Your answer
Any successful treatments ? *
Your answer
Any current or past occupations ? *
Your answer
Any hobbies ? *
Your answer
Do you have any goals ? *
Your answer
Any advice to anyone ? *
Your answer
Anything you would like to add ? *
Your answer
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