Register at GFB Registry

Name*
Surname*
Age*
Name of the disease*
Do you have genetic (DNA) confirmation of the disease?*
Yes
No
Gender*
Male
Female
Email*
Telephone*
+39
    Address*
    Postal Code*
    City*
    State*
    Other remarks

    By signing up, the GFB will send you updates via email on cutting edge research, clinical trials, and info that is important to you as an individual living with Limb Girdle Muscular Dystrophy.

    I have read and accept the Privacy Policy

    Submit

    ©2020 GFBONLUS.IT - GRUPPO FAMILIARI BETA-SARCOGLICANOPATIE
    +39 328 0075986 This email address is being protected from spambots. You need JavaScript enabled to view it.

    Via Civasca 112 23018 Talamona - SO  Italia

    Made by Betsoft