About The Contact Registry

The CLiC Patient Contact Registry is a method by which patients (and their families) with rare liver diseases can register themselves to be contacted in the future about clinical research opportunities. An online Registry form exists for all the CLiC diseases currently being studied:

• Alagille Syndrome
• Alpha-1 Antitrypsin Deficiency
• Bile Acid Synthesis Defects
• Mitochondrial Hepatopathies
• PFIC (Progressive Familial Intrahepatic Cholestasis)

Available for Download: CLiC Patient Contact Registry Brochure [.pdf]

Download the Contact Registry Paper Form

New! The Rare Diseases Network has created a paper version of the Contact Registry form. This form can be downloaded by Physicians and Advocacy Groups in order to provide the form to those who need assistance outside the internet.

All forms are two pages, which MUST be printed on one sheet of paper (front and back). Once you have opened the form, select print from the file menu. When the printing dialogue box opens, the 2-side printing option can usually be found by clicking "properties."

• Download: CLiC Contact Registry Paper Form [.pdf]

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