I agree to the terms and conditions set forth above and permit the information I provide to APFED via the Physician locator survey to be displayed on the APFED website. This information will be available to the public. Please do not provide information you do not want displayed on a public website. Updates can be sent to email@example.com as needed. If at any time you would like your information removed from our website, email firstname.lastname@example.org to request removal of your survey responses from the website. Your information will be purged from our database promptly.
If you have any questions about this disclaimer and consent statement, the practices of our surveys, or suggestions on how we can improve our physician locator process, please contact us. I have read the above the above information and consent to have my information as provided in the self-reported survey displayed on the American Partnership for Eosinophilic Disorders website, www.apfed.org.