English
Français
Registration
Signup as Professional
Personal Information
Email / User name:
*
This field is required.
Please input a valid email.
Password:
*
This field is required.
Confirm Password:
*
This field is required.
Password doesn't match
Personal Information
Prefix:
--Select One--
Mr.
Mrs.
Mr. & Mrs.
Miss
Ms.
Dr.
First Name:
*
This field is required.
Last Name:
*
This field is required.
Institution:
*
This field is required.
Specialty:
Contact Information
Phone:
Website:
Contact Information
Address:
Address 2:
City:
Country:
Province/State:
Zip/Postal Code:
Do you want to be notified of new information about MPS through the Canadian MPS Society e-newsletter?
Yes
No
*
This field is required.
Have you diagnosed a child with MPS?
Yes
No
*
This field is required.
Have you Treated a Child with MPS?
Yes
No
*
This field is required.
If yes to either of the above questions, what type(s)?:
MPS I-H (Hurler syndrom)
MPS III D (Sanfilippo syndrome D)
MPS I-S (Scheie syndrome)
MPS IV A (Morquio syndrome A)
MPS I-HS (Hurler-Scheie syndrome)
MPS IV B (Morquio syndrome B)
MPS II (Hunter syndrome)
MPS VI (Maroteaux-Lamy syndrome)
MPS III A (Sanfilippo syndrome A)
MPS VII (Sly syndrome)
MPS III B(Sanfilippo syndrome B)
MPS IX (Hyaluronidase Deficiency)
MPS III C (Sanfilippo syndrome C)