HCC Health Care Access Forum 2/29/2024
Register to attend the Health Care Access Forum on February 29, 2024. This Forum is a HYBRID in person/virtual event that will take place from 10:00 am to 12:00 pm.  An optional Networking hour starts at 9:15 AM virtually.  Lunch is included for all attendees after the Forum. In person meeting location is at the Capitol Event Center (1020 11th Street) in Sacramento.

For those wishing to attend virtually, you will receive your Zoom login information in February for this Forum meeting.

Registration is limited to Healthcare Access Forum members (according to your membership level).  Additional tickets are available to companies - you can purchase them at http://www.hemophiliaca.org/education/health-care-access-forum/

If you have any questions, please email Andrea at apalladino@hemophiliaca.org.

PLEASE NOTE:  There is a SEPARATE registration for the CA Rare Disease Access Coalition meeting in the afternoon on 2/29/2024.  To register for the Coalition, you can visit https://www.hemophiliaca.org/ca-rda-coalition/.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Phone Number
Attending in person or via Zoom? *
If you are attending in person, will you be participating in the networking hour? (Mark N/A if you are attending virtually.) *
If you are attending in person, lunch will be provided.  Do you have any dietary restrictions?
If you are attending in person, will you be joining us for lunch? (Mark N/A if you are attending virtually.) *
ATTENDEE LIABILITY WAIVER AND ASSUMPTION OF RISK:  Attendee assumes all risks and accepts sole responsibility for any injury (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that attendee may experience or incur in connection with attending the Health Care Access Forum. Attendee hereby releases, covenants not to sue, discharges, and holds harmless Hemophilia Council of California, its employees, agents, and representatives, of and from any such claims, including all liabilities, claims, actions, damages, costs, or expenses of any kind arising out of or relating thereto.  Specifically relating to the global COVID-19 pandemic, attendee acknowledges the highly contagious nature of COVID-19 and voluntarily assumes the risk of exposure or infection by attending the Health Care Access Forum, and that such exposure or infection may result in personal injury, illness, disability, and/or death to attendee. Attendee understands that the risk of becoming exposed to or infected by COVID-19 at the Health Care Access Forum may result from the actions, omissions, or negligence of others who may attend the event or their families, colleagues, or others with whom they may have contact. Accordingly, attendee understands and agrees that this release includes any claims based on the actions, omissions, or negligence of Hemophilia Council of California, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in the Health Care Access Forum. *
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.
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hemophilia Council of California. Report Abuse