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DIPG WARRIORS

Dear Sir or Madam, please take a few minutes of your time to complete the following questionnaire.

Secured
1

First name and first initial of last name of warrior

2

How old was your child at diagnosis?

3

How old was your child when passed?

If child is still fighting please state that down below
4

Gender of child with DIPG?

Select one or more answers
5

When did you notice signs and what were those signs?

6

What trials did you do? If any were offered

Which hospitals
7

Did you do radiation?

Select one or more answers
8

How many rounds of treatments or radiations?

9

What medications were or is your child on?

10

Did your child get the Covid shot or had Covid?