Stevens-Johnson Syndrome Awareness Wristbands

If you have a family member diagnosed with an Stevens-Johnson Syndrome or are interested in supporting the SJS awareness cause, fill out the form below and we'll send you an SJS awareness wristband — free of charge.

Please limit all wristband requests to four or less.

Name
Address
City, State, Zip
Phone #
Email
Free SJS Packet
Name
Address
City, State, Zip
Phone #
Email
Diagnosis
Drug Used
Comments
Free SJS Wristband
Free Case Evaluation