NCKDSS Questionnaire

Welcome to the NCKDSS. This form will be sent to the NCKDSS Board of Directors.

If you have any questions, please contact Shella Thoman at nckdssbuddywalk@yahoo.com or call 785-275-1777.

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First
Middle
Youngest
Trisomy 21
Mosaic
Translocation
Not Sure
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No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
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No
Prefer Not To Answer
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No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Prefer Not To Answer
Yes
No
Maybe