Transition to Adulthood Working Group Interest Form

Transition to Adulthood Working Group Interest Form

The chILD Foundation is launching a new working group to develop a real transition support program for young people with chILD moving from pediatric to adult care. This group will bring together patients, families, and professionals to define the program and shape the research questions that will guide it. Details on time commitment and meeting schedule are being finalized — complete this form, and we will be in touch.
Section 1: Contact Information
Name

First NameLast Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Section 2: Your Role

Select the option that best describes you:
I am a:

Other
If you are a patient aged 13-17, please list the name(s) of you parent(s) or guardian(s) and their email.
If you are any kind of medical professional or researcher, please list your organization/place of work and your job title.
Section 3: Your Experience
Briefly describe your experience or interest in chILD transition to Adult care
Have you personally navigated the transition from pediatric to adult care for chILD?
Are you aware of any formal transition program at your institution?
Section 4: Additional Information
Is there anything specific you hope this working group will address?
How did you hear about us?
Should be Empty:

Section 1: Contact Information