International and German Conference for people and families affected by aHUS, C3G and IC-MPGN

International and German Conference for people and families affected by aHUS, C3G and IC-MPGN
Name*

First NameLast Name
Email*
example@example.com
Phone Number*

Area CodePhone Number
Affiliation
Your organization
Country*
Role*

PatientCaregiverPatient representativeClinician / NephrologistOther
Which disease do you or the person you care for have?*

aHUSC3GIC-MPGNOther
Will you attend the meeting (28-30 November, 2025)*

Friday afternoonSaturday (all day)Sunday morningAll three daysOnly virtually
With family?

YesNo
Do you need child care?

YesNo
How many family members and the age of the kids?
Will you be staying at Jugendherberge, Heidelberg International Tiergartenstr. 5, 69120 Heidelberg? (Should financial concerns prevent you from attending, feel free to contact us in confidence)*

YesNo
Language preference*

GermanEnglish
Please list any topics you would like to discuss during the event
Social activities: Please indicate if you would like to join the following:*

Friday: Visit to the Christmas markets and dinner at the city centerSaturday: Social dinnerNone
Do you have any allergies, dietary restrictions, etc.? Other disability accommodation needs we should be aware of?*

NoneYes (please specify)
If yes, please specify
Additional comments: Please let us know about any special requests or other information you would like to share. (Should financial concerns prevent you from attending, feel free to contact us in confidence)
Should be Empty: