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.
All data collected in this form will be solely used for this event. To find out more information about the EHC Data Privacy policy, please consult the EHC website (www.ehc.eu/data-privacy-policy)
First Name *
Your answer
Last Name *
Your answer
Organisation *
Your answer
Email Address *
Your answer
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?
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:
Your answer
Do you have reduced mobility? *
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? *
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