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Download the Phenotype form HERE Icone fichier (585Kb)



Patient Registry


Purposes of the registry are:

  • To share information about patients in order to facilitate collaboration for funding, research and publications

  • To create systematic phenotyping of GnRH deficient patients

       

Patient Registry Charter

  • To receive a copy of the Charter please contact Andrew Dwyer.

  • To participate in this registry, please return the signed Charter to Andrew Dwyer.

Inclusion Criteria:

  • Idiopathic hypogonadotropic hypogonadism

  • Kallmann syndrome

  • Constitutional delay of growth and puberty

  • Combined pituitary hormone deficiency

Who can submit a patient:

     

Any investigator in this COST Action (BM1105) can submit de-identified patient data if they have valid patient consent by a document approved at their institution.

How to submit a patient:

  • Download THIS password protected file Icone fichier (585Kb)

  • Obtain a password to open the form by submitting a request.

  • IMPORTANT: Please verify that Javascript is activated for this document before filling it out.

  • Complete both pages of the form

  • Rename, Save and Print a copy the document BEFORE sending it

  • Submit the form by using the CLICK TO SEND button at the end of the form

  • The form will be reviewed and you may be contacted to provide clarifications

  • Your submission and subsequent inclusion in the database will be confirmed by email