Outcomes+ Parent/Patient Email List
Name (person filling in this form)
Phone Number (used for backup if email bounces)
Will you provide some basic information about your connection with vesicoureteral reflux (VUR)?
What is your relationship to VUR? Check All That Apply.
Parent/caregiver of a child diagnosed with VUR
Person who has/had VUR
Family member or friend of someone who has/had VUR
Are you the parent/caregiver of a child who was diagnosed with a urinary tract infection (UTI) or kidney infection?
Do Not Fill This Out