Rett Syndrome Registry Form - International Rett Syndrome Foundation

Rett Syndrome Registry

The Rett Syndrome Registry is designed to increase the chances of clinical trial success and help bring curative treatment options to families. Sign-up below to become a partner in research. We will contact you about taking part in the Rett Syndrome Registry™ and connect you with your nearest IRSF Center of Excellence.

Name*
Prefix First Last
Relationship to Individual with Rett Syndrome*
If Other, please indicate relationship to individual with Rett syndrome.
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
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