Survey - SED HydrocephalusCONNECT Email Request

SED HydrocephalusCONNECT Email Request

Hydrocephalus CONNECT

Do you have a question about hydrocephalus? Treatment? Ongoing care? The impact of the condition on all aspects of life?
You can submit them via email here!

Our cyber volunteers are ready to answer your questions and share their experience via email

HA Support Form:

Field Is Required What is your connection to the Hydrocephalus Association?

Hydrocephalus Type

Field Is Required Patient Diagnosed Age

Primary Cause of Hydrocephalus

Primary Shunt Type

VA (Heart)
VP (Abdomen)
LP (Spine)
VPL (Lung)

Field Is Required What is the patient's date of birth?

Please provide your name, email and zip code

Field Is Required First

Field Is Required Last

Field Is Required ZIP / Postal Code:

Field Is Required Email:

Yes, I would like to receive postal mail from Hydrocephalus Association

Keep me logged in. What's this?

What is your Hydrocephalus question?