HCU Newborn Screening Story Form

Please fill out the form below to share your patient/family’s newborn screening story. Thank you!

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* 1. Name

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* 2. Tell us about you:

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* 3. What type of Homocystinuria was the patient diagnosed with?

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* 4. In what state or U.S. territory was the patient born?

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* 5. Share your HCU Newborn Screening Story

  1. Please describe the patient's journey to diagnosis i.e., HCU was caught at birth, received a delayed diagnosis, etc. (Please include the year the patient was born and diagnosed).
  2. If the patient received a delayed diagnosis, please share the impact it had on the patient and the family.
  3. If the patient received a delayed diagnosis, please describe the full range of symptoms (from physical to mental health) leading up to diagnosis.
  4. Looking back on the time you were diagnosed, is there something that you would have done differently or wished you had learned sooner?

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* 6. Please upload any pictures you'd like to share with your HCU Newborn Screening Story.

PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only.
Choose File

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* 7. Please supply your email or phone number for us to follow up with any additional questions.

By hitting "Submit", you consent to permitting HCU Network America to share your story on our internal and external materials (i.e., newsletter, website, conference materials, etc.).

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