CDKL5 Patient Registry: Register For An Account

Create an account to take part in our study and help advance CDKL5 gene therapy research.

Personal Information

First Name *

Last Name *

Email * 📧

Telephone *

Role *

Patient Name

Date of Birth

Date of CDKL5 Diagnosis

Mutation Type (if known)

Current Treatments

Country *

State/Province

City

Postal/Zip Code

Interested in clinical trial participation?

Yes, very interested Maybe, need more information No, not at this time

Preferred Method of Contact

Questions or Additional Information

Password * 🔒 Minimum of 6 characters

Confirm Password * 🔒

I consent to participate in the CDKL5 Patient Registry and understand my data will be used for research purposes. *

I have read and agree to the Privacy Policy and Terms of Service. *

I would like to receive updates about CDKL5 gene therapy research and clinical trial opportunities.

500+

Families Registered

Countries Represented

Q2 2026

Trial Start Date

Contact our patient registry coordinator:

Email: registry@cdkl5genetherapy.com

Phone: 1-888-555-4363