Jewish Ozzies' Inter.Net
The electronic voice of the Australian Jewish Community


" Tay-Sachs disease is one of the genetic diseases which affect Jewish communities worldwide. "

Tay-Sachs disease is an inherited incurable disease of the central nervous system. One in 26 people of Ashkenazi Jewish heritage carries a copy of the faulty gene responsible for the disease. Knowing your carrier status will provide you with information which allows you to make earlier informed choices.

If you are 16-35 years old please print out, complete and return the following questionnaire. If you have already been tested let your friends know.

TAY-SACHS SURVEY - December 1998

1. Is either of your parents of Ashkenazi Jewish descent?
Yes( ) No ( )

2. Testing is available currently on Sundays at the Wolper Hospital.
Is this a suitable location and time?
Yes( ) No ( )

If NO Where and when would you prefer to be tested?
University ( )
On weekend ( )
Hakoah Club ( )
Weeknight ( )
During term ( )
During holidays ( )
Other ( )
Specify _______________

3. Because testing is very expensive the community is subsiding part of the cost. Testing for full-time students and unemployed may be partially or wholly subsidised. Is this important to you?
Yes( ) No( )

(The regular charge is $40.00-$120.00 per test depending on program chosen.)

4. Other genetic diseases such as cystic fibrosis, Canavan disease, and Fanconi anaemia can also be tested for at the same time as for Tay-Sachs disease. We have printed detailed information sheets which we can send to you.
Yes Please ( ) No Thank You ( )

Please complete your details.

Name: ______________________________ Date of Birth:_____________

Address: _______________________________

Contact phone number:_________________

Email address: ______________________

Please print out, then mail or fax your completed form to:

Anne Proos
Kolling Institute of Medical Research
RNS Hospital, St Leonards NSW 2065, Australia
Ph: +61-2.9926-8899 Fax: +61-2.9926-8484

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