Take Our Survey :: National Tay-Sachs & Allied Diseases Association of Delaware Valley (NTSAD-DV)

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