Submitted by XanthomAdmin on Mon, 10/06/2014 - 16:01 Welcome to PXE International! Please complete all fields below. PXE International will contact you shortly.PXE International is committed to protecting your privacy. Contact Information I am updating my information. I am updating my information Prefix - None -Mr.Mrs.Mr. and Mrs.Ms.Dr.Prof.Hon. Please select one: First Name * Last Name * Address 1 * Address 2 City * State/Province * Postal Code * Country * - Select -AfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong Kong S.A.R., ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth KoreaNorwayOmanPakistanPalauPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabwe Telephone Telephone Type - None -Home PhoneCell PhoneWork Phone Alternate Telephone Alternate Telephone Type - None -Home PhoneCell PhoneWork Phone Email AddressAs a registered member of PXE International, with a valid email address, you are automatically subscribed to our one-way PXE Announcements email list and our monthly eNewsletter. Email is the very best and most direct way that PXE International has for keeping you up to date. Email * Confirm Email * PXE Chat Email List I would like to subscribe to the PXE Chat email list. The PXE Chat email list is a closed discussion group - a place to pull up a chair and chat - about PXE or anything else that is important. PXE Chat is an optional email group open to anyone registered with PXE International with a valid email address and interested in PXE, including individuals with PXE, their families, friends or doctors. Pseudoxanthoma Elasticum (PXE) Information Gender * Female Male Date of Birth * Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year19031904190519061907190819091910191119121913191419151916191719181919192019211922192319241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018 I have Pseudoxanthoma Elasticum (PXE) I have PXE I would like to donate a sample of DNA. Please send me a saliva collection kit. Yes DNA Collection PXE International is collecting DNA from people with PXE to accelerate research on treatments for PXE. You can easily and painlessly donate your DNA by saliva sample. PXE International will send you a small saliva collection kit with instructions, and a prepaid return envelope. I have a relative with PXE I have a relative with PXE My relative with PXE is my: MotherFatherSisterBrotherWifeHusbandDaughterSonAuntUncleCousinGrandmotherGrandfather Please provide a name of your relative(s) with PXE so that PXE International can properly identify your relationship if your relative is also registered with us. I have a friend with PXE I have a friend with PXE Please provide a name of your friend with PXE: Share Info I would like contact information for people who have Pseudoxanthoma Elasticum in my area who agreed to share their information. Yes No You may share my contact information with other people who have Pseudoxanthoma Elasticum and are looking for someone in my area: Yes No I have a question: PXE International Contact InformationPXE International 4301 Connecticut Ave NW Suite 404 Washington DC 20008 Voice: 202.362.9599 Fax: 202.966.8553 Email: firstname.lastname@example.org Facebook: http://on.fb.me/PXEinternational feed me To prevent automated spam submissions leave this field empty. CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Math question * 7 + 5 = Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.