NATIONAL TAY-SACHS & ALLIED DISEASES Association of Delaware Valley

Take Our Survey

 

 

How old are you?
 
Are you male or female?
   Male   Female
What is your religion by birth?
 
What is your ethnic background?
   
Other:
Have you been screened for Tay-Sachs disease?
   Yes   No
If yes, where
(e.g. Dr.'s office, Tay-Sachs Lab at Jefferson, other hospital lab, synagogue):
 
If you have not been
screened, check all
reasons that apply to you:
 It never occurred to me
 Both my parents are known to be non-carriers
 One parent is known to be a non-carrier
 Don't think I need to be
 Concern about insurance ramifications
 Cost
 Other, please explain
      
Are you aware of a history of Tay-Sachs carriers in your family?

 

 Yes   No
If yes, relationship?
Were you screened for
Tay-Sachs through an
NTSAD-DV program?
 Gift of Life
 Free student testing
 Free first Tuesday testing
 May Tay-Sachs Month community screenings
Today, the Tay-Sachs carrier rate in the American (Ashkenazi) Jewish population is:
 
Today, the Canavan carrier rate in the American Jewish population is:
 
As you may know, Irish Americans are at increased risk for Tay-Sachs.
The carrier rate in this population group is approximately:
 
Do you find the IMPACT informative and worth reading?
   Yes   No
If you were born to at least one Jewish parent,
please continue responding to the following:
Have you been screened for Canavan disease?
   Yes   No
If yes, where (e.g. Dr.s office, Tay-Sachs Lab at Jefferson, other hospital lab, synagogue):
 
If you have not been
screened, check all the
reasons that apply to you:
 It never occurred to me
 Both my parents are known to be non-carriers
 One parent is known to be a non-carrier
 Don't think I need to be
 Concern about insurance ramifications
 Cost
 Other, please explain
      
Are you aware of a history of Canavan in your family?
   Yes   No
If yes, relationship?
Were you screened for Canavan through an NTSAD-DV program such as Gift of Life, Free student testing, Free First Tuesday, May Tay-Sachs Month?
   Yes   No