Register With FRR

The Foundation for Retinal Research (FRR) would like to invite you to join our registry of individuals/families with Leber Congenital Amaurosis (LCA).

The purpose of this registry is to collect contact information from individuals/families with LCA so we can keep you updated with new developments in research and treatments. Please fill out the form below to register with the FRR. Thank you!

First Name

Last Name

Address

City

State

Zip

Country

Phone

E-mail

Person with LCA

LCA Gene

Birth date of person with LCA (mm/dd/yyyy)

Where Diagnosed?

Where was the blood screened?

Doctor

Relationship to person affected by LCA

Siblings

How did you hear about the FRR?

Is there anything we can do to make this webpage more accessible to you?