Name

Email

Date of Birth

Street Address

City

State

Zip Code

Phone Number

CF Center Name and Location

The date and/or age you were diagnosed

A brief description of your childhood and how you and your family has dealt with CF.

Describe your daily treatment, medication, and exercise regimen

What motivates you to stay healthy?

What was your worst day with CF?

What was your best day with CF?

Do people know you have CF? Do you tell people?

What do you do for fun?

What are your goals, both in your career and personal?

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