Via Castel Giubileo, 11 - 00138 Rome (RM) Contact center: + (39) 06.164161500 (12 lines PBX) Fax : +(39) 06 64492025 Via Enrico Cialdini, 16 (Affori Centre) 20161 Milan (MI) Contact center: + (39) 06.164161500 (12 lines PBX) Fax : + (39) 02 36637461
Genetic Disorder of Concern(e.g. Cystic Fibrosis, Fragile X) Indication for PGD:(e.g. Cystic Fibrosis, Fragile X, Beta Thalassemia combined with HLA matching) Other Indication: (e.g. Advanced maternal age, recurrent miscarriages, repeated implantation failure, PGS, Chromosomal Translocation) Case Summary: (Brief description of the case) Pedigree:
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Clinic Name Address PGD Coordinator with whom we can communicate Phone (Or Work Mobile) Fax Best Email *** VERY important for us to interact with you and coordinate your case