HCC Health Care Access Forum (12/2/2021)
Register to attend the Health Care Access Forum on December 2, 2021. The forum will take place from 10:00 am to 12:00 pm ONLINE via Zoom. You will receive your Zoom login information in September for this Forum meeting. An optional Zoom networking time will take place 9:15 AM - 10:00 AM.

Registration is limited to Healthcare Access Forum members (2/company membership). Additional tickets are available to companies - you can purchase them at http://www.hemophiliaca.org/programs/health-care-access-forum/
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Email *
First Name *
Last Name *
Phone Number *
Title
Company *
MEDIA RELEASE: MEDIA RELEASE: During this program, photographs, audio and video may be taken to document the program. I hereby grant the HCC, its assignees, contractors, licensees, sponsors and transferees permission to record my likeness and voice and the right to use my likeness, voice and name in any professionally produced or distributed products or materials, for any broadcast of the products or materials, and any publicity for the aforementioned products or materials. I understand that such use may include publication, media reproduction, audio and/or video broadcast, internet distribution/access and other uses as desired by the HCC and its employees from and against any and all liability arising out of or connected in any way with the use of reproductions of my image, voice, or text. *
A copy of your responses will be emailed to the address you provided.
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