Join Our Family Network!

Every year, the 22q DS Clinic publishes a family directory for individuals with 22q DS and their families, so that they have an opportunity to network and communicate. To join our directory, just fill out this simple form. After verifying your information, we will send you a directory within 2-4 weeks of your request.

Download this form in PDF format

First Name of person completing form:
Last Name or person completing the form:
City of Residence:
Province/State:
Country:
E-mail address:
Alternate e-mail address:
The first person with 22qDS in my family is:and was born in (year)
First person's Date of Birth (yyyy/mm/dd):
The second person with 22qDS in my family
is (if applicable):
and was born in (year)

Please note it is your responsibility to update us with your most current email address.
Accounts with bounced or unrecognized emails will be deleted from this list. To update your information please email rozmin.visram@sickkids.ca

By clicking the button below you agree:

  1. To have your information (as entered above) published in our electronic family directory and circulated to other members.
  2. To receive email updates regarding the 22q11 DS Clinic, its programs and related resources.
  3. That all the information you provided above is accurate to the best of your knowledge.
Please enter the security code as shown in the image. (Case insensitive)

Visual verification