Region 4 Genetics

In an effort to evaluate and improve its products, the Region 4 Genetics Collaborative would like your input. Please take a minute to respond to the following questions. Your responses will be completely anonymous. After you submit this form, you will have the opportunity to download the guide. Thank you for your time!

1. How did you learn about the guide?

2. Are you a healthcare provider?

3. Do you serve children with genetic conditions?

4. Are you a parent or caregiver of a child with a genetic condition?

5. Are you a family member or friend of a parent or caregiver of a child with a genetic condition?

6. How do you anticipate using the Guide? Please select all that apply.

As an educational tool for myself
As an educational tool for my clients/patients
As an educational tool for my healthcare provider
As a care planning tool
As an advocacy tool
Other
Unsure

7. In what state do you live?

8. Would you be willing to consider completing a follow up survey about the guide?

Submit