Required. 150 characters or fewer. Letters, digits and @/./+/-/_ only.
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Your relative (or yourself) affected by a genetic disorder or part of the ValDEV project (Valproate/Depakine):
Example: if you are the sister, please select "Sister".
You need to specify at least one of the three following causes of your or your relative's disorder.
Either you or your affected relative carries a causal mutation in a gene (e.g. KANSL1, EHMT1, ANKRD11, etc.)...
If a gene is not in our list, or a second gene is also involved, please specify it in the field above.
... or another genetic defect like duplication/deletion, trisomy, translocation, imprinting defect, etc. (e.g. 17q21.31 deletion, trisomy21, etc.)...
If the genetic defect is not in our list, or a second one is also involved, please specify it in the field above.
... or is part of the French ValDEV project (Valproate/Depakine).
All fields with a star (*) are required.
Don't forget to specify the cause of your relative's disorder (gene / genetic defect / ValDEV project).