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Registration: HHT Ireland Patient Online Forum 2021
Event Timing: 24th April, 2021 at 10.30am -2.30pm.
Event Address: online via Zoom
Your information is gathered for HHT purposes only.
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First Name
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Your answer
Surname
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Your answer
Street Name
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Your answer
Town
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Your answer
County
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Your answer
Email
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Your answer
Do you have HHT?
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Yes
No
Dont know
If YES, tick relevant box(es)
Lung
Brain
Liver
Gastro-Intestinal
Nose
Other:
During the meeting we will be covering three topics of conversation. Please tick the conversation you are most interested in.
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Raising Awareness of HHT
Financial aspects to HHT
Where are our HHT specialists?
Are you familiar with the Zoom app?
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Yes
No
Type of device you will connect to the online forum
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PC
Smartphone
Tablet
Laptop
Other
Would you be interested in a short tutorial in Zoom before our Patient Forum takes place?
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Yes
No
Many thanks from the team at HHT Ireland
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