Sjögren’s India Event - July 2021
Sjögren’s India is planning a virtual event for patients and their families to learn about conquering Sjögren’s syndrome and Living like Champions! Your responses will help us design a programme that would be meaningful for you. The information you provide will not be shared with anybody.
If you need help filling the form, please leave a message on or send a WhatsApp message on Sjogren’s India Helpline +91 8200749362 and we will get back to you.

Kirtida Oza
Co-Founder Director
Sjögren’s India
Patient's Name *
If you are filling the form for a patient please give your name and how the patient is related to you.
Patient's Gender *
Contact e-mail
Phone number for Contact (Preferably WhatsApp) *
Please enter your phone number without any spaces. For numbers other than India please include the ISD code. If you have problems entering your number please include it in the 'other information' section at the end of this form.
City *
Patient's Age *
How may years ago did the patient get a confirmed diagnosis of Sjögren’s syndrome? *
Sjogren's India has a Patients/Family Members Only WhatsApp Group. Please indicate your response. *
Sjögren’s India is planning a Virtual Event for Patients and Family in July 2021. Are you interested in attending. *
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