JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Atlanta Chapter Meeting registration
Join the Atlanta Hope for HS Chapter for empowering community sessions designed for individuals living with Hidradenitis Suppurativa (HS).
Our next event is on August 16th, from 2-4 PM
in-person
at Grady Memorial Hospital. More details to come!
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Full Name
*
Your answer
Are you a patient or immediate caregiver of someone with HS?
*
Choose
Yes
No
Medical Professional or Student associated with Hope for HS
Are you able to attend in-person at Grady Memorial Hospital?
*
Yes
No
Required
Is there a specific question you'd like to ask the HS dermatologists during the Q&A?
(
you may also ask questions during the event
)
Your answer
Would you be interested in sharing your HS story during the event?
Yes
No
Maybe
Clear selection
How did you hear about this support group event?
Your answer
Do you have any dietary restrictions?
Your answer
Information presented in this meeting is not a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician with any questions you may have regarding a medical condition or treatment.
*
Choose
Accept
Decline (Your registration will be denied)
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hope for HS.
Does this form look suspicious?
Report
Forms
Help and feedback
Contact form owner
Help Forms improve
Report