Parent of an individual with Moebius syndrome

Parent Information

An adult with Moebius syndrome
A parent of a child with Moebius syndrome
A friend or family member of someone with Moebius Syndrome
A professional working with Moebius syndrome

A critical part of the Foundation's Mission is to learn as much as possible about our members so we can best meet their needs. Please answer the following confidential questions about your child.

// (mm/dd/yyyy)
Yes
No
Yes
No

Eye Issues
Dental Issues
Feeding Issues
Hearing Issues
Limb Difference
Speech Issues
Sleep Issues
Social/emotional issues (depression/anxiety/social issues)
Vision Impairment
Poland syndrome
Intellectual disabilities
Autism spectrum disorder
Complex medical needs

A parent of a child with Moebius sydrome in my child's age range
A parent of a child with Moebius syndrome in my geographic area
A parent of a child with complex medical needs

Dental issues
Eye Issues
Feeding issues
Hearing issues
Limb difference
Sleep issues
Speech issues
Social/emotional issues(depression/anxiety/social issues)
Vision impairment
Poland syndrome
Intellectual disabilities
Autism spectrum disorder

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