New Coffin-Siris Syndrome Diagnosis

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Did you or someone you love recently get a new CSS diagnosis? Welcome to the Coffin-Siris Syndrome community. You are part of a good community. We'd like to send you a welcome letter, some resources, and a couple of stickers.

Email *

Name of Person with CSS *

Your First Name *

Your Last Name *

Relation to Person with CSS *

Address

Where should we send it?

Street Address *

City *

State *

Zip Code *

Any information you would like to share about the diagnosis? (Such as gene, age, or anything else you want to share.)

Coffin-Siris Syndrome Foundation does not share your contact information with any other agency or business without explicit permission, but we may use it to get in touch with you about CSS related items.

Yes, I am okay with that.

Required

Keep me updated on CSS community news. (Probably 1-3 emails per year.) *

Yes

Send me a copy of my responses.

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