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About EAD
What is an eosinophil-associated disease?
Enfermedad eosinofílica
EGIDS
EoE
Acerca de la EoE
EC
EG
EGE
Episodic Angioedema with Eosinophilia (Gleich’s Syndrome)
Eosinophilic Asthma
Eosinophilic Cystitis
Eosinophilic Fasciitis
Eosinophilic Granulomatosis with Polyangiitis
Eosinophilia-Myalgia Syndrome
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World Eosinophilic Disease Day (May 18)
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Annual Patient Education Conference (July 11-13, 2024)
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Apfed 2024 Conference Registration Form
EOS Connection 2024 – Registration (Updated)
Registration options
*
Please select a registration type.
Virtual conference access: No cost
Name
*
Prefix
Mr.
Mrs.
Miss
Ms.
Dr.
Prof.
Rev.
First
Last
Suffix
Email
*
Email consent
*
Would you like APFED to contact you with information about other events, news of interest, and opportunities to support the eosinophilic community?
Yes, please add me to APFED’s email list
No
Phone
*
Company/organization
If you are attending the conference on behalf of a company or organization, please provide the name below.
Relationships
*
What is your relationship to eosinophil-associated diseases? Please select all that apply.
Patient
Parent of patient
Family of patient (e.g., brother, aunt, grandparent, cousin)
Spouse of patient
Friend of patient
Clinician
Researcher
None
Disease subsets
*
Please indicate what eosinophil-associated disease(s) you are impacted by.
Eosinophilic Esophagitis
Eosinophilic Asthma
Episodic Angioedema with Eosinophilia (Gleich’s Syndrome)
Eosinophilic Colitis
Eosinophilic Cystitis
Eosinophilic Fasciitis
Eosinophilic Gastritis
Eosinophilic Gastroenteritis
Eosinophilic Granulomatosis with Polyangiitis (aka Churg-Strauss Syndrome)
Eosinophilia-Myalgia Syndrome
Eosinophilic Pneumonia
Hypereosinophilic Syndromes
Other
Other subset
Please specify what other subsets you are interested in.
Is this your first APFED Conference?
*
Yes
No
How long has it been since diagnosis?
*
1 year or less
2-5 years
10+ years
Not applicable
How did you learn about this event?
*
Friend or family member
Healthcare professional
Online search engine
Another organization
Social media
News story
Conference or meeting
Scientific journal
Other
Event Waiver/Terms
*
EOS Connection, APFED’s Annual Patient Education Conference, (and related events, including miscellaneous social and gaming activities; collectively, the “Event”) is a charity event sponsored by the American Partnership for Eosinophilic Disorders (“APFED”). In consideration of APFED permitting me (or my child, who is under the age of 18) to participate in the Event, I have read and understand this statement and agree to assume all risk for personal injury or other physical or emotional ailment for me (or my child). Further, I (or my child) hereby, and for my (or my child’s) legal representatives, heirs, executors, administrators, assigns, and all guardians, WAIVE, RELEASE AND DISCHARGE ANY AND ALL RIGHTS, CLAIMS AND CAUSES OF ACTION OF ANY NATURE, DIRECT OR INDIRECT, INCLUDING THOSE FOUNDED IN WHOLE OR PART UPON NEGLIGENCE, that I (or my child) may have against APFED and/or its collective sponsors, its directors, officers, employees, agents, chapters, assignees, licensees, volunteers and any cooperating entities, their representatives, heirs, executors, administrators, successors, and assigns (the “Released Parties”) arising out of or resulting from any and all injuries or damages of any nature, including death, which I (or my child) may suffer while taking part in or arising out of the Event or any activity connected with the Event. Photo Waiver For Onsite Attendees Only: If I (or my child) attend the conference in person, I (or my child) hereby consent to use my (or my child’s) name and any photographs, digital images, portraits, likenesses, writings or biographical information, audiotape and/or videotape recordings, sound or silent motion pictures of me (or my child) in any medium for news releases, use on the APFED website, editorial, educational, promotional, and advertising purposes, for the solicitation of contributions and/or for any other purpose in furtherance of the charitable purposes and objectives of APFED. I understand that I may opt out of this photo waiver by requesting a special NO PHOTO badge onsite at the conference registration desk and will agree to wear a special badge at all times to indicate to photographers that I do not want to be photographed. By registering for this conference, I certify that I have read these terms and fully understand them. This agreement shall be binding upon me (or my child), my (or my child’s) legal representatives, heirs, executors, administrators, and assigns (and all legal guardians of my child).
Yes, I have read and agree to the event waiver/terms and the conference
Code of Conduct
.
Legal
*
I have read and agree to APFEDs
Terms of Use
and
Privacy Policy
.
Comments
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