CMD Community Peer-to-Peer Match

Would you like to connect 1:1 with someone in the community traveling a similar CMD journey?

Cure CMD has launched a new program designed to help facillitate peer-to-peer conversations about topics affecting all of us. You may have questions about managing early to secondary educational barriers, or about how to effectively advocate with your healthcare team. Perhaps you'd just like to talk to another person or family about their journey with CMD.

If you are interested in being matched with someone in the CMD community, please complete this survey!

Note: We are currently only accepting adults into the peer-match program.

If you are the parent/caregiver of a minor-aged child or teenager who would like to be matched with another affected kiddo around their age, please indicate their name and age in the comment section below.

If you are the parent/caregiver of an adult child who would like to be matched with another affected adult, please ask them to register separately. Thank you!

Your Name:

First NameLast Name

Do you have a partner (spouse, co-caregiver, etc.) who would also like to participate?

First NameLast Name

Your Email Address:

example@example.com

Your Phone Number:

Area CodePhone Number

Your Partner's Email Address:

example@example.com

Your Partner's Phone Number:

Area CodePhone Number

Location:

Street Address

Street Address Line 2

State/Province

Country

Timezone:

Please indicate YOUR community affiliation (check all that apply):

Other

Please indicate your PARTNER's community affiliation (check all that apply):

Other

Please indicate YOUR age:

Please indicate your PARTNER'S age:

Your/Your loved one's CMD Subtype:

Please indicate "other" CMD/LGMD subtype.

Please indicate your affected child's birth year (YYYY). If you have more than one affected child, indicate all birth years, separated by commas.

Affected Individual's Ambulatory Status:

Affected Individual's Breathing Status

Affected Individual's Feeding Status

Please indicate the topics below for which you are interested in RECEIVING peer support:

Please indicate the topics below for which you are interested in PROVIDING peer support:

Comments:

The views and/or advice expressed between peer-support matches do not represent the opinion of Cure CMD. Medical or legal opinions expressed or shared should not be substituted or interpreted as medical or legal advice. Please consult your healthcare provider regarding any health related concerns.