Be part of Rare Disease Day by sharing your story with others OR A DEDICATION and send a message of solidarity!

PRRF will compile these rare retinal disease stories and dedications into a short presentation. We plan to launch the video via email and social media at 12:00 NOON ET on February 29th.

If you would like to share a photo or short video as well please email it to info@pediatricrrf.org.

Name

First Name

Last Name

Email

Disease

Your Story or Dedication

Consent confirmation

I understand that these materials may be published on PRRF’s website, and this may disclose my personal and protected health information online. However, PRRF’s online disclosure of my name and residence will be limited to my child’s first name and the geographical location where he or she receives services. PRRF does not need to submit these materials to me for approval. I understand that these materials may be modified and that PRRF may decide not to use them.

I agree

February 29, 2024

Be part of Rare Disease Day by sharing your story with others OR A DEDICATION and send a message of solidarity!

Pediatric Retinal Research Foundation

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