Department of Pediatrics

Registration/Update Form - National Congenital CMV Disease Registry


Parent/Family Update Form


By completing the form and clicking "submit" below, I am indicating that I am willing to continue being part of the CMV support group network. I understand that my name, address and phone number will be made available to other families of CMV children who are seeking advice and support.


Please provide a brief description of your child's abilities/disabilities. For example: "At age 3 years, our child is functioning at the 15-month level, has microcephaly, and has some hearing loss, but he is very happy and is just beginning to walk."