Please only complete this survey one time per person. If a child is too young to answer the 2 questions, please complete for your child.

Please answer this question if you have any form of FSHD. Which statement most pertains to you?

I am 16-70 and can walk 10 meters (33 feet).

I am younger than 16 and can walk 10 meters (33 feet).

I am older than 70 and can walk 10 meters (33 feet).

I am (at any age) NOT able to walk 10 meters (33 feet).

Please answer this question if you have any form of FSHD. Which statement most pertains to you?

I was diagnosed with FSHD as an ADULT and didn't have or notice symptoms until I was an adult.

I was diagnosed with FSHD as an ADULT and had some mild symptoms as a child. I had a pretty typical childhood.

I was diagnosed with FSHD as a CHILD and/or had significant symptoms as a child. I currently am NOT able to walk 10 meters (33 feet).

I was diagnosed with FSHD as a CHILD and/or had significant symptoms as a child. I am older than 70 and can walk 10 meters (33 feet).

I was diagnosed with FSHD as a CHILD and/or had significant symptoms as a child. I (or my child) is younger than 16 and can walk 10 meters (33 feet).

I was diagnosed with FSHD as a CHILD and/or had significant symptoms as a child. I am 16-70 and can walk 10 meters (33 feet).

More Surveys