Patient Advocacy Booth Registration Form

The EADV Patient Association Working Group invites you to participate with your Patient Association at our EADV 31st Congress from the 7th to the 10th September in Milan.

By participating, you will have the opportunity to present your work at the “Patient Advocacy Booth”, that is fully supported by the EADV. You will also be able to see the work of the other participating patient associations, while also discussing and sharing patient advocacy best practices and resources with visitors.

Participating organisations in the Patient Advocacy Booth must be not-for-profit patient organisations that demonstrate a charitable mission, are engaged in patient advocacy activities, and provide services and support for people with dermato-venereology conditions.
Selected organisations are required to be present at their booth during the official Congress hours on the selected timeslot assigned by the Patient Working Group. Timeslots will be communicated in July 2022.
Patient representatives are responsible for arranging their travel and accommodation at own costs.
Upon formal acceptance, recipients are committed to attend the Congress and be present at their booth at the assigned timeslot. In case of inability to attend, they must immediately inform the EADV.
Applicants will be informed of the outcome of their application by e-mail in July 2022. Free registrations are also subjected to confirmation.

Patient association

Patient Association name*

Acronym (if applicable)

Address*

Street Address City ZIP / Postal Code Country

Main contact

Name*

Prefix First Last

Email*

Enter Email Confirm Email

Phone*

Two patient representatives can benefit from a free access to the Congress. In order to receive your free ticket/s please complete the section below.

Patient Representative 1

Name*

Prefix First Last

Email*

Enter Email Confirm Email

Gender

Male
Female
Other

Birth date

Nationality*

Country

Country of residence*

Country

Heathcare Professional*

Yes
No

Patient Representative 2

Name*

Prefix First Last

Email*

Enter Email Confirm Email

Gender

Male
Female
Other

Birth date

Nationality*

Country

Country of residence*

Country

Heathcare Professional*

Yes
No

Terms & Conditions*

I agree to the EADV General Terms & Conditions

You can find the EADV General Terms & Conditions HERE