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Patient information
First Name *
Last Name *
National ID *
Phone Number *
Province *
City *
Date of Starting Illness
Select date of starting illness
SMA Type
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Treating Physician
Medical Images and Documents
Upload medical images and documents related to your condition, including doctor's referral letters, genetic test results, EMG/nerve conduction studies, etc. Note: This condition typically does not involve imaging like MRI. Accepted formats: JPG, PNG, PDF. Maximum file size: 10MB per file.
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Your information helps connect you to national support.
