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Sign Up for Individuals

By completing the below Sign Up form, you can become part of Patient and Caregiver Support Groups, and/or receive notification of Fundraising Events, the proceeds of which will support ECEF’s Mission Statement.

Do you want to be part of a Support Group? yes no
Are you an Esophageal Cancer Patient?  yes no
Are you the Caregiver of an Esophageal Cancer Patient?  yes no
Do you have Barrett’s Esophagus? yes  no
Do you have Acid Reflux?  yes  no
Are you a Medical Professional?  yes  no
Want to receive invitations to Events?  yes  no
Would you like to Volunteer to help ECEF?  yes  no
Would you like to help Raise Money for ECEF?  yes  no
Disclaimer: This information is for educational purposes only, It is not to diagnose or treat your disease. If you do use the information contained on this web site without the approval of a health professional, you are prescribing for yourself, which is your constitutional right, but the author(s) and webmaster assume no responsibility

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