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SHANK2 Patient Registry: Register For An Account
Create an account to take part in our study.
First Name
Last Name
Email
Telephone
Role
Mother
Father
Sibling
Caregiver
Researcher
Do you have more than one child with SHANK2?
No
Yes
How many total children with SHANK2 do you have?
2
3
Password
Minimum of 6 characters
Confirm Password
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