Patient Registry Questionnaire

AA&MDSIF maintains a Patient Registry for patients with aplastic anemia, myelodysplastic syndromes (MDS) and paroxysmal nocturnal hemoglobinuria (PNH). Since these are not reportable diseases as required by the Federal government, government statistics are not available to assist research and medical studies. By completing and returning the AA&MDSIF questionnaire to us, this information can be used for future statistical analysis to help discover the cause and prevention of these diseases.

Fill out the online questionnaire below or print and return competed form to : AA&MDSIF, PO Box 310, Churchton, Maryland 20733.