Enrollment Information

Participants can be enrolled through a referring physician/genetic counselor or can contact Linda Reis, MS, CGC, Study Coordinator, to enroll directly in person or via phone/mail.

Documentation

Enrollment Packet Link (PDF)

An enrollment packet must be completed for EVERY individual who provides a sample

  • A signed consent form must be included for each sample submitted with minor assent obtained for individuals ages 7-18 years.
  • Note that the Medical Records Release form needs to be completed for each person, including unaffected individuals.
  • Please complete an Authorization for Disclosure of Patient Health Information for ophthalmology records.
  • When possible, include photographs of the affected individual’s eye(s) and facial features.

Sample Requirements:

  • 10 cc blood (or 1 ml/kg for children) into an EDTA (purple top) tube.
  • Label tubes with patient’s name, date of birth, and date collected.
  • If blood sample cannot be collected, please contact Linda Reis for information about DNA or buccal sample submission.
  • Sample collection kits can be provided upon request.

Dr. Semina Lab Contact

Linda Reis, MS, CGC
Study Coordinator
(414) 955-7645 | Fax: (414) 955-6329
lreis@mcw.edu

Elena Semina, PhD
Director
(414) 955-4996 | Fax: (414) 955-6329
esemina@mcw.edu

Pediatrics Developmental Biology
Translational & Biomedical Research Center, Third Floor
Children's Research Institute
8701 Watertown Plank Road
Milwaukee, WI 53226

Medical College of Wisconsin
8701 Watertown Plank Road
Milwaukee, WI 53226
(414) 955-8296
Directions & Maps
© 2015

Page Updated 08/04/2015
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