Sickle Cell Disease Symposium Registration

Sickle Cell Disease Symposium - Research Updates and Advocacy Training
Saturday, November 8, 2014 10am- 3:30 pm
(registration opens at 9:30)

Main Auditorium - 2nd floor
Children's National Medical Center
111 Michigan Ave, NW
Washington, DC 20010

Parking validation and lunch will be provided
Child care will not be provided

Please register by October 20, 2014

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* Please provide the following contact information:

First Name

Last Name

Email address

Mailing address

City

State

Zip code

Phone number

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* How many people will be attending the symposium?

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* Names of others attending the symposium (please include ages of the children):

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* Have you attended the Bone Marrow Transplant for Sickle Cell Disease symposium in the past?

Yes

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* What is your level of interest about Bone Marrow Transplant for Sickle Cell Disease?

I want to learn about bone marrow transplant for sickle cell. I haven't decided if it's the right choice for me and my family.

I am very interested in bone marrow transplant, but am still trying to decide when I want to do it

I plan on having a bone marrow transplant within the next year

Other (please specify)

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* Please provide the following contact information:

Question Title

* How many people will be attending the symposium?

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* Names of others attending the symposium (please include ages of the children):

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* Have you attended the Bone Marrow Transplant for Sickle Cell Disease symposium in the past?

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* What is your level of interest about Bone Marrow Transplant for Sickle Cell Disease?

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* Please list any questions about Sickle Cell Research Studies that you would like answered at the Symposium.