Please fill out the brief screener below to determine whether you are eligible to submit a Patient Registry application.


Are you currently a legal adult (at least 18 years old and the age of majority in your state)?


Are you a U.S. citizen or permanent resident?


Do you have any of the following conditions: quadriplegia, paraplegia, visual impairment or blindness, aphasia or the inability to speak, or hearing impairment or deafness?