FIRST TIME REGISTRATION

If you have Alpha-1 Antitrypsin Deficiency Type ZZ, SZ, Z (null) (null) or S (null) please complete the below forms to join the Alpha-1 Canadian Registry.  Forms can be downloaded, completed and uploaded here OR downloaded, completed and emailed directly to info@alpha1canadianregistry.com

  1. Consent Form
  2. Baseline Form
  3. Saint George’s Respiratory Questionnaire (SGRQ)
  4. Release of Medical Information Form
  5. COPD Assessment Test (CAT)

ANNUAL FOLLOW-UP FORMS

If you are already registered with the Alpha-1 Canadian Registry and you have been asked by a Registry Coordinator to complete annual follow-up forms, those forms can be downloaded, completed and uploaded here OR downloaded, completed and emailed directly to info@alpha1canadianregistry.com

  1. Follow Up Form
  2. COPD Assessment Test (CAT)
  3. Saint George’s Respiratory Questionnaire (SGRQ)
  4. Release of Medical Information Form

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