Thought this might help everyone

[Guest guest]

Hi!

Some are emailing me they are having a problem with the form on the CJD Watch

site. So this is my remedy - sending the form through the list (see below),

just copy and paste it into an email and fill in the info...

I think this might help everyone. If you all will fill it our & email it to

me, and anyone else you may have in your files too! I will be able to get

them on the CJD Watch site today and tomorrow, hopefully!

Thanks,

Barb

CJD Watch Submission Form

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Information submitted to this list will be included in the CJD Watch Project

on the internet. Information is optional, and you may submit any information

you deem not invasive to your privacy. This is an important project and the

more complete the information, the more complete the research.

Thank you for helping CJD Watch in its efforts to track the horrendous

CREUTZFELDT JAKOB DISEASE!

CJD Victims Profile:

Note: The Victims name is optional, but preferred. The more information for

the victim, the more accurate will be the research.

First name

Last name

Sex

Date of Birth

Date of Death

Length of Illness from first symptom

Type of CJD (If known)

Legal Residence: County & State

Where was victim born and raised?

Country if not USA

Major Surgeries

Dental Surgeries

Travel outside the US

Recipient of Blood

Branch of US Service if applicable

History of Seizures

Use this form to describe the surgeries and/or for Comments:

Please identify and describe yourself, the submitter of this information:

First name

Last name

State

Organization

E-mail

URL

Please email this info to: stacy91434@...