First name:
Age:
Country, city:
Occupation:
Bleeding Disorder:
Type:
How much does the bleeding disorder affect your life?
Which possibilities for treatment do you have?
What kind of contact do you have with other young people with bleeding disorders?
What would you like to know about other young people with bleeding disorders around the world?
<Please note: Your answers should not be more than one page>
What do you do to keep yourself fit?
Do you participate in any kind of sports?
If yes, which kind?
Have you ever had to quit a sport due to your bleeding disorder?
Have your parents/doctor interfered with your choice of sports?
<Please note: Your answers should not be more than one page>
Deadline
15th April 2006