DISCON Membership Database

The database of the Disability & Sickle Cell Organization of Nigeria (DISCON) is developed for people living with Sickle Cell Disorder (SCD) and those with disabilities that may have occurred as a result of it. This would make healthcare delivery, resource sharing and communication with members easy, transparent and structured. Kindly complete this form. All Information will be treated confidentially.

Email Address: (required)

First Name: (required)

Last Name: (required)

Date Of Birth:

Phone Number:

Gender:
MaleFemale

Marital Status:
SingleMarriedDivorceWidowWidower

Genotype Status / Variant:(Required)

Genotype Test Date & Place:(Required)

Address:

Your Cause:

Your Message: