Myotonic Dystrophy Steinert disease

 

 

 

 

 

HOW CAN YOU BE PART OF THE REGISTRY?


Registry's Registration forms

You can request the forms by mail by contacting our offices or you can download them from this website. You can select the appropriate forms for your situation. If you have any questions, contact our offices. Once downloaded, you can print the forms, fillOnce downloaded, you can print the forms, fill them out and return them to our offices by mail.

Different types of forms:

Contact:

Phone: 418-654-2186
Toll free: 1-877-424-7494
Email: admregistry@crchul.ulaval.ca

Send your form to:

CHUQ-CHUL
Administration du Registre Dystrophie myotonique
Laboratoire de génétique, RC 9300
2705 Boulevard Laurier
Quebec, QC, G1V4G2

The registration forms in English are presently unavailable,
the Ethical Committee approval is pending.

 

 

Non affected Patient

pdf  Consent
pdf  Question


Affected Patient

pdf  Consent
pdf  Question
pdf  Request

 

 

 

Unaffected child

pdf  Consent
pdf  Question


Affected Child

pdf  Consent
pdf  Question
pdf  Request