Barth Syndrome Foundation
 
Home | Contact Us | Sitemap | Donate Now!   
  Search  
  Home > E-Mail Contact_Barth Syndrome Trust

E-Mail Contact_Barth Syndrome Trust

 We want to answer questions you may have.  Please complete this form.

*required fields


*Your Last Name:
First Name:
Title:
Institute/Organization:
Field of Specialty:
Street Address:
*City:
State or Province:
Postal Code:
*Country:
Your E-Mail Address:
Your Telephone Number:
*Subject:
I have a medical emergency related to Barth syndrome
I, or my child, have Barth syndrome
I think I, or my child, may have Barth syndrome
I am a physician or healthcare professional treating a patient who has been diagnosed with Barth syndrome
I am a physician or healthcare professional treating a patient who I think may have Barth syndrome
I am a physician or healthcare professional interested in performing research on Barth syndrome
I am a physician or healthcare professional interested in information related to the Human Tafazzin (TAZ) Gene Mutation and Variation Database
I am a physician or healthcare professional interested in the Barth Syndrome Registry and DNA Bank
I am a student interested in researching Barth syndrome
I would like to help your organization
I would like general information about your organization and/or Barth syndrome
I am with the media and would like to correspond with someone from your organization
Other
Message:
Submit