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First Name
Last Name
Last Name
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Do you have a mutation or variant in a disease risk gene in your family?
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Are you interested in exchanging your contact information with people in other families who have the same variant? If you select “Yes”, we will share first name and email with others with the same variant.
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What is your family's gene and variant gene with c. or p.? (optional)
What is your family's gene and variant gene with c. or p.? (optional)
If you do not know the variant details, you can upload a photo of your test report (optional)
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In what language do you want us to speak with or write to you? (optional)
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Where do you live? [City, State/Province, Country] (optional)
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How did you find out about ConnectMyVariant? (optional)
Are you interested in a navigator helping you with family outreach (optional)
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Maybe, tell me more about this.
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Are you interested in being contacted about research projects related to your variant? You will be asked about participating in specific projects before being included in research. (optional)
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