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HKL Rare Disease Day 2025 RSVP Form / Pendaftaran
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Salutation / Salam Hormat
*
Mr / Encik / Sir
Miss / Cik / Puan / Madam
Dr
Other:
Your Name
*
Your answer
Please confirm your attendance for the following:
*
28 Feb, 10:15AM - Majlis Perasmian
28 Feb, 2:45PM - Sesi Bersama Pesakit Rare Disease
Required
Where are you from?
*
Hospital Kuala Lumpur
Hospital Tunku Azizah
Malaysian Rare Disease Society (MRDS)
Motor Neurone Disease Malaysia (MND Malaysia)
Persatuan Epilepsi Malaysia (PEM)
Genetic Counselling Society Malaysia (GCSM)
Clinical Research Malaysia (CRM)
DEBRA Malaysia
Persatuan Syndrom Prader-Willi Malaysia (PWS)
Malaysia Lysosomal Diseases Association (MLDA)
Malaysian Patient Organisation for Primary Immunodeficiencies (MYPOPI)
Persatuan Spinal Muscular Atrophy Malaysia (SMA)
SMA Care
My Heart Foundation
Kuala Lumpur and Selangor Albinism Association (KLSAA)
Lions Club Kajang
Lions Club Selangor Majestic
Lions Club Puchong
Pharm-D
Other:
Profession
*
Doctor
Nurse
Therapist
Dietitian
Pharmacist
Medical Officer
Specialist
Social welfare worker / volunteer
Other:
Mobile Number
*
Your answer
Email Address
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Your answer
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