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First Name*

Last Name*

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What is your relationship to TRND/TCF7L2?*

What is the approximate date of diagnosis with TRND/TCF7L2 mutation?

Please input the date of diagnosis with TRND or the date on which a TCF7L2 mutation was found, to the best of your recollection.

What is the approximate age at the time of diagnosis with TRND or a TCF7L2 mutation?

Please input the approximate age of the patient at the time of diagnosis with TRND or a TCF7L2 mutation. If you are unsure, please let us know.

Which of the following symptoms are present in the patient with TRND or a suspected TCF7L2 mutation?

What institution do you belong to?

If you are a physician or researcher, please let us know what institution, hospital, research lab, or office you work at.

Please state your reason for joining our network.