Vasculitis Pregnancy Registry Consent Form

VPREG Consent Form

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Are you female?(Required)

Are you a patient with vasculitis?(Required)
Please confirm which type of vasculitis you have? (Please select only ONE)(Required)

Are you currently pregnant?(Required)
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Join the Study(Required)

We are looking forward to hearing from you as you go through your pregnancy – we will ask questions about how your vasculitis is doing, what medications you are taking, and how your pregnancy progresses.