Advisory Boards

Name*

First Last

Phone*

Email*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

I am a....*

If you are a parent/ grandparent/ sibling, please include the child's full name and birthdate:

First Last

Child Birthdate

In order to develop tools to empower our diverse rare disease community, we are asking our participants to please select the response that best reflects their race and ethnicity in the following questions.

What gender best reflects your identify?

Which race or ethnicity best describes you?

Have you or a member of your family ever served on active duty in the US Armed Forces, Military Reserves, or National Guard?

Name

This field is for validation purposes and should be left unchanged.

Advisory Boards

Clinical/Scientific Advisory Board (CSAB)

Ann Scheimann, MD, MBA

Ann Manzardo, PhD, MS

David M. Agarwal, MD

Moris Angulo, MD

Merlin G. Butler, MD, PhD, FFACMG

Mary Cataletto, MD

Gregory Cherpes MD

Jessica Duis, MD, MSc

Janice Forster, MD

Linda Gourash, MD

Waheeda Hossain, MD, MPH

Janet Li, MD

James Loker, MD

Shawn McCandless, MD

Jennifer Miller, MD, MS

Matt Rivard, MD, MBA, FACS

Amee Revana, DO, FAASM

James Resnick, PhD

Daniela Rubin, PhD, FACSM

Parisa Salehi, MD

Althea Shelton, MD, MPH

Deepan Singh, MD, FAPA

Harold J.P. van Bosse, MD, FAAOS

Stefanie Varga, PhD

Olivia Veatch, PhD

Barbara Y. Whitman, PhD