Application for PFS genetics study
Please complete this form if you wish to participate. We will gather responses and be in touch when we are ready to begin collection. 
Email *
What is your full name? *
What is your mailing address, for purpose of sending sample collection kit?  *
How old are you?  *
Have your PFS symptoms persisted since you completed the propeciahelp patient survey? *
Are you willing and able to collect a small blood sample within your home and mail it back to our partner, Dante Labs? *
Link to Propeciahelp member story or Reddit profile *
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