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Name*

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Email*

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Phone Number

Area CodePhone Number

Address*

Street Address

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CityState / Province

Postal / Zip Code

Share my location? By default, we like to share the City/State that you provide here within the story on our website. If you prefer to have your location remain anonymous please select No..*

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Patient's first name*

Title of your story*

Please tell us about your CADASIL journey.*

Tip: Stories should be no longer than 10,000 characters. We love to hear your story in full. When did your symptoms first begin? At birth? Later on in life? How did your symptoms affect your every-day life? What sort of doctors did you see? What sort of exams did you have? How and when were you diagnosed—and with what? Have you gone through any therapies or clinical trials? What is the outlook for the future? And lastly—what sort of advice do you have for other patients who may be going through a similar diagnostic journey?

Upload a photo of the patient for use on our website.

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I hereby release all parties from any liability for furnishing this information. Further, I hereby release, without expecting payment, cureCADASIL and their respective employees, officers and agents from any and all liability which may arise from the use of my photo, likeness, and/or experiences as a volunteer with cureCADASIL in any publications, including electronic or audiovisual presentations, news media stories, promotional materials, written articles, videotape and/or photographs. I understand that I can revoke this release any time in writing and that the use of any of my photos or other information authorized by this release will immediately cease.

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cureCADASIL Association is committed to equal opportunity for all persons and all volunteer recruitment decisions will be based on merit, suitability for the role and experience. All volunteer recruitment decisions are made without regard to race, color, age, religion, creed, national origin, ancestry, physical or mental disability, sexual orientation, gender identity, sex, veteran or military status, marital status, genetic information or any other legally recognized protected basis under federal, state or local law. cureCADASIL Association fully endorses a working environment free from discrimination and harassment.