Please take the time to fill out this contact list form so that others may contact you in times of need or just for a general chat.
Please note that it may take a few days for your post to be entered onto the "Contacts" page.
Your Name:
Your Email Address:
DON'T FORGET!!!!!!!!!!!!!
How old are you?
What city/country do you live in?:
Do you have any of the following forms of Instant Messaging?
Your ICQ Contact Number:
Your MSN Contact ID:
Your AIM Contact ID:
Your Yahoo Messenger Contact ID:
Type Of IBD (Inflammatory Bowel Disease)
(Please enter, as this helps me know what category to put your info in):
Ulcerative Colitis
Crohns Disease
Indeterminate Colitis
Crohns/Colitis
Hirschsprungs Disease
Cancer
Familial Polyps
Other:
Type Of Ostomy Surgery
(please enter, as this helps me know what category to put your info in):
Ileostomy
Colostomy
Urostomy
BCIR
J Pouch
Kock's Pouch
Jejunostomy
Resection
No Surgery Yet
I have experienced pregnancy with an ostomy
I am the Parent of an Ostomate
I am the Partner of an Ostomate
I am the Caregiver (not partner) of an Ostomate
Any additional info you'd like to add:
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