Growing Connections GHD Video Participant Survey
Thank you for your interest in this patient support program with
MAGIC Foundation, sponsored by Pfizer. Our goal is to provide
support to families new to, or currently using, growth
hormone treatment via real-life stories, experiences, and
advice.
If selected, you, your child, or another family member will tell their story using a smartphone or tablet to create a short video. To begin the process, please complete the form below.
This information will not be used in any way outside of this
purpose.
This questionnaire will be used for GHD caregivers to sign up to
participate in this unbranded program (share their experiences
with Growth Hormone Deficiency as part of the unbranded Growing
Connections program). This information will not be used in any way
outside of this purpose.
For background, Growing Connections is an unbranded
Peer-to-Peer program being created in partnership with
The MAGIC Foundation and will provide a holistic support system to
newly diagnosed patients with a focus on emotional and social resources to navigate the journey. Please
note this will be an ongoing program – not all participation requests will be granted immediately, however we
hope to have all that want to participate involved during this program’s lifespan.
This question requires an answer.
* 1. Parent/guardian full name
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* 2. Parent/guardian email
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* 3. Parent/guardian phone
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* 4. Parent/guardian full address
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* 5. Primary language spoken at home
This question requires an answer.
* 6. Do you or your child speak any other languages fluently?
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* 7. Child’s age
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* 8. Child’s age at growth hormone deficiency diagnosis
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* 10. How long has your child been on GH treatment?
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* 12. What has been the largest roadblock you have had to overcome in regard to your child’s GH treatment?
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* 13. What do you wish you could tell new families just starting GH treatment?
Thank you for your interest in participating in the
Growing Connections program.
On behalf of Pfizer and MAGIC Foundation, a Rarity Health representative will reach out to you regarding next steps.
If you know of another GHD family who may want to participate in this program, please share this link: www.myGHDstory.com
On behalf of Pfizer and MAGIC Foundation, a Rarity Health representative will reach out to you regarding next steps.
If you know of another GHD family who may want to participate in this program, please share this link: www.myGHDstory.com
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