Access to care questionnaire

Access to adult care for patients with Turner Syndrome
Turner Syndrome Foundation is your advocate. Let us know what is important to you!
My connection to TS
Name

First NameLast Name
Birthdate

MonthDayYear
Age of Diagnosis
E-mail

Confirmation Email
State

Street Address

Street Address Line 2

CityState

Zip Code
I live within __ hour(s) of a major city.
It is difficult for me to find:
In my area, I can find:
In my area, I cannot find:
In my area, I can easily find:
I have a copy of the NIH Clinical Care Guidelines for Turner Syndrome.
Send me:
Questions or concerns:
KNOW A GOOD PROVIDER?

Share contact info for a provider, or two, whom you have found to be helpful or knowledgable. Thank you for sharing!
Practice Name:
Doctor's Name:
Tele#:
Specialty

Other
Additional info:
Should be Empty:

Access to adult care for patients with Turner Syndrome