Impact Statement (optional)
Rare disease patients often miss school or work or have limitations regarding activities in which they can participate. Please feel free to write an optional impact statement (300 words or less) telling us about any disease-related complications such as missing school, work, or participation in extracurricular activities, that impacted your achievements. This optional statement should describe complications such as hospital stays, doctor visits, or limitations you experience due to living with a rare disorder that have an impact on your academic or personal achievements.
Acceptable file formats are .doc, .docx, .pdf, .jpeg, .jpg