AMC Doctor Information Collection Form
Please use this form to submit contact information for physicians that treat individuals with Arthrogryposis Multiplex Congentia (AMC). Information submitted via this form will be compiled into a downloadable list made available via the AMCSI website. If you have any questions, please contact Lori Kennedy at <insert email address>.
Doctor, Therapist or Special Name (first and last)
Your answer
Facility (where do they see patients)
Your answer
Specialty (if multiple please list all)
Your answer
Address
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City
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State
Postal Code
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Country
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Phone
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Fax
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Email Adress
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