Sickle Cell Warriors - Simona Ephraim Foundation

Join The Sickle Cell Warriors

Fill The Form Below To Join The Community of Sickle Cell Warriors

Your information will be kept confidential and used only for community support purposes

Full Name

Date of Birth

Phone Number

Location

Genotype (e.g. SS, Sβ⁰, Sβ⁺, SC)

Are you a Sickle Cell Warrior or a Caregiver/Parent?

If caregiver: Name of the warrior

How often do you experience crises?

Main triggers you experience: e.g.(cold, stress, dehydration)

What type of support do you need?

Name of Emergency Contact

Phone of Emergency Contact

I understand that my details will be kept confidential and give permission for the community to contact me when needed

This community stands with you every step, every day. Thank you for being part of this warrior family