United Leukodystrophy Foundation


Patients & Family

Family Communication Network

The United Leukodystrophy Foundation is updating our Family Communication Network.

If you wish to remain active, or to participate in the ULF Family Communication Network, please fill out and return the form below.

Network Consent Form

I hereby give permission to the United Leukodystrophy Foundation to release my name, address, telephone number, and email address to members only of the United Leukodystrophy Foundation for the express purpose of strengthening family support and establishing more direct communication between Leukodystrophy families.

You must be a dues paying member. Want to join? Click here

* Required Fields
First Name* :
Last Name* :
Address:
City:
State:
Country:
Zip:
Phone* :
Email* :

Type of Leukodystrophy:
I/We Are:
Wish to network with:
Experiences to share:





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(c) United Leukodystrophy Foundation, Inc.
Sycamore, Illinois USA
www.ulf.org






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