Registration form - EHC Round Table on Pain Management in Haemophilia
On Tuesday 11 June, the European Haemophilia Consortium (EHC) will held its second Round Table of Stakeholders of 2019 on the topic of 'Pain management in haemophilia.' The event will be held at the Renaissance Brussels Hotel from 13.30 to 16.30 hrs. Registrations and a light lunch will be held from 12.30 to 13.30 hrs.
Do you agree to have your name and organisation on the participants' list, which will be distributed to all participants and uploaded on the EHC website following the event?
If you are a speaker, do you agree to have your presentation shared with participants on the day and uploaded on the EHC website?
Yes, I agree to have my presentation shared with the events' participants
Yes, I agree to have my presentation shared in PDF on the EHC website
Yes, I agree to have my presentation shared with participants on the day and on the EHC website as a PDF document
No, I do not wish to share my presentation
Do you have any dietary restrictions (due to, e.g. allergies, special diets, religious beliefs, etc.)?
If you have indicated yes, please let us know what your dietary requirement is:
Do you have reduced mobility?
Yes, I use a wheelchair
Yes, I walk with the support of crutches
A photographer will take pictures during the event. These pictures will be used in the EHC's communication material, for example, its newsletters, annual reports, website and Facebook Page. Do you agree that the EHC may use pictures of the event in which you appear for its communication material?
Yes, I agree to have my pictures used in EHC communication material
No, I do not wish to have my picture appearing in EHC communication material
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