In the late Fall of 2005, this form stopped functioning when, due to security
concerns, Netcarrier stopped supporting MAILTO.EXE,
the CGI executable required to run it. Efforts are being made to restore
its functionality as soon as possible.
Familial IPF Questionnaire
Please fill out this
form to participate in ongoing studies of Idiopathic Pulmonary Fibrosis
(IPF). Results will, with your permission (see below), be sent to the National
Institute of Health (NIH) in Bethesda, MD and to Vanderbilt University.
Important--All information provided
herein is kept strictly confidential. I never reveal your personal information
or use it for any purpose other than that for which it has been provided.
Thank you for taking out the time to
complete this form. Hopefully, we can add to the medical community's
awareness of the pervasiveness and often widely varying characteristics
of this terrible disease, and perhaps in doing so, help to identify it's
My sincere hope is that with additional
information comes additional progress.
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Copyright ©1997-2006 by Roger W. Stevens.
All rights reserved.
Comments? Email me here.