HCC Health Care Access Forum 2/17/2022
Register to attend the Health Care Access Forum on February 17, 2022. The forum will take place from 10:00 am to 12:00 pm ONLINE via Zoom.  You will receive your Zoom login information in February 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).  If you have not yet renewed your company 2022 membership, you can visit https://hemophiliaca.org/education/health-care-access-forum#Membership or email Lynne at lkinst@hemophiliaca.org.  Additional tickets are available to companies - you can purchase them at http://www.hemophiliaca.org/education/health-care-access-forum/

If you are attending the following Health Policy Summit, separate registration is required.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Phone Number
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. Note: Please omit initials if you choose not to grant permission for media reproduction and distribution. *
A copy of your responses will be emailed to the address you provided.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hemophilia Council of California. Report Abuse