Error message

The spam filter installed on this site is currently unavailable. Per site policy, we are unable to accept new submissions until that problem is resolved. Please try resubmitting the form in a couple of minutes.

What laryngeal cleft symptoms does your child have?

What laryngeal cleft symptoms does your child have?
Introduction
I'm creating a little survey to see what symptoms most frequently are seen with children who have laryngeal cleft. After the survey is done I will share the results only with the parents who have submitted the survey.
Personal Details
Plesase fill out your personal details. They will not be used for commercial purposes. It's just so I know you are not a robot and that I can reach out to you with the results of this little survey.
Fill out your e-mail address to which we can send the results of the survey.
Symptoms
What laryngeal cleft symptoms does your child have? Or do you recognize?
YesNoUnknown
stridor
aspiration
recurrent pneumonia
chronic lung disease
dysphagia
hoarseness
choking
chronic cough
failure to thrive
cyanosis
regurgitation/reflux
feeding difficulties
shortness of breath
apnea
Please choose the symptoms you recognize or suspect your child has.