SCAF Database for Persons Living with Sickle Cell Disorder
On the 27th of February 2020, Nigeria recorded its first confirmed case of COVID-19. Since then, there has been an exponential increase in confirmed cases all over the country. As an organization whose major focus is on ensuring access to quality health care and welfare of persons living with Sickle Cell Disorder (SCD), the Sickle Cell Aid Foundation (SCAF) is committed to ensuring that persons with SCD are protected during this pandemic.

Globally, It has been recognized that persons living with SCD are particularly vulnerable, with a higher risk of severe complications than the general populace. It should also be noted that Nigeria has been cited as a country with the highest population of persons living with SCD. Various statistics have proven that over 150,000 babies are born with SCD every year. A significant percentage of them live below the poverty line.

Recognising this challenge and the potential impact of COVID-19 on persons with SCD in Nigeria, SCAF seeks to collate a database of patients with SCD across the country. Our aim is to ensure the welfare of those living with SCD during the pandemic and beyond. It is our hope that this database will provide a platform for the government and other stakeholders to track, monitor and cater for persons living with SCD. It is also our desire that this will be used for research purpose in Nigeria.

We will also use this database to identify indigent persons and provide them with free essential medications and basic supplies during the imposed quarantine period across the country. In addition, we will partner with Mental health organizations to provide access to platforms for emotional and mental health support for persons with SCD on the database.



To register on this database, please fill the form below:
First Name *
Last Name *
Date of Birth
MM
/
DD
/
YYYY
Genotype *
Required
Phone number / (Whatsapp number)
Address *
State of Origin
Local Government Area
Email Address
Full Name of Care Giver / Next of Kin (State Relationship)
Contact Number of Care Giver/Next of Kin
Name and Location of Attending Hospital
Name of Usual Attending Doctor and Contact
Employment Status:
Monthly Income
Can we contact you for more information?
Clear selection
Comment
Data Protection
You hereby explicitly and unambiguously consents to the collection, use and transfer, in electronic or other form, of the information provided in this form by the Sickle Cell Aid Foundation.We will treat your information with respect & utmost confidentiality. The data gathered shall not be disclosed to any third party, except to SCAF’s employees, agents, consultants, partners or contractors who need to have access to such information and solely for research and collation purposes and shall be bound to keep these information confidential.
SCAF shall not be liable for any cost, expense, or legal actions that may arise ​from any action or inaction, taken in good faith with respect to the form. SCAF shall also be indemnified and held harmless against all actions, costs and expenses which may arise as a results of acts or omissions with respect to this form.
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy