Testing Application FormUpdated on November 19, 2021November 19, 20180 min read Testing – Fundraiser Application (updated 9-2022) Your Name * Your E-mail * Your Phone Number Dropdown * AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Dropdown AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Patient’s First Name * Patient’s Middle Name or Initial Patient’s Last Name * Patient’s Year of Birth Patient’s Year of Death (if applicable) Are you a member of CDH Internatinal? (join for free at http://www.cdhboards.org) * YesNoI don't knowSigning up now Please tell us 5 interesting things about the patient. (see the featured images for example) How has CDH International helped you? (this might be quoted on our site, social media and/or a press release) Are you presently holding a fundraiser or event that you would like us to promote? Please give us all information to share. (date, location, web site, etc) Please write 1 paragraph (3 or 4 sentences) about your diagnosis and pregnancy. (this might be quoted on our site, social media and/or a press release) Please write 1 paragraph (3 or 4 sentences) about surgery and NICU. (this might be quoted on our site, social media and/or a press release) Please write 1 paragraph (3 or 4 sentences) about your present situation; coming home, current status, grief, etc. (this might be quoted on our site, social media and/or a press release) Do you give us permission to use you / your child’s photo in publications, on social media and to share with the media? * YesNo Do you give us permission to use you / your child’s photo in other publications? (web site, yearbook, calendars, guides, etc)? YesNo File Uploads – 3 photos please (birth, now, family) (.jpg or .png file format only) * Drop a file here or click to upload. (.jpg or .png format only please) Choose File Maximum file size: 134.22MB File Uploads – Video of your story. See instructions below please. Drop a file here or click to upload. (video format please) Choose File Maximum file size: 134.22MB reCAPTCHA If you are human, leave this field blank. Submit
November 19, 2021November 19, 2018 Uncategorized RESEARCH: “Congenital diaphragmatic hernia in newborn infants: Variable endotracheal tube and umbilical venous catheter positions”
