VOICES of the NEXT GENERATION

This section enables each of you to share your experiences and will hopefully provide beneficial contacts.

YOUR INPUT AND CONTRIBUTION IS GREATLY NEEDED AND APPRECIATED. THANK YOU.


Today's Date:(numerical-Month and Year)   (Required)

Your name:   (Required) (May be your screen name.)

Your email address:  (Required)

Your WebPage URL:   (Optional)

Test Participant's Name:   (Required)

Test Name and/or Series:   (Required)

Branch of Service and Unit: (If known)   (Required)

Do you have medical problems which you believe resulted from parental radiation exposure? YES or NO

Are you willing to be contacted for additional information? YES or NO

Address or Phone Number:   (Optional)

Your comments:


      



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