Saturday, September 12th at 12PM ET via Zoom
Featuring "Ask a Doc" open forum: in a casual Q&A session, physicians will answer your questions about vitiligo science, treatment, and research. Don't miss it!
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
What country do you live in?
*
Ethnicity
*
Gender
*
Male
Female
Perf not to answer
Do you have vitiligo?
*
Yes
My Spouse
My Child
My Parent
Yes, and my child
Yes, and my spouse
No, I'm a supporter
Heathcare Provider
How did you hear about this event?
*
Email Invitation
Social Media (Facebook, Instagram, Twitter, etc.)
Website or online search
Friend or family member
Heathcare provider
Support group
Advertising or flyer
Other
Is this your first time attending UNITE
*
Yes
No
Is there a topic you would like to hear about? Or do you have a question you would like to see answered?
Are you in Vitiligo support group?
*
Yes
No
No, there is not one in my area
If you answered yes, please put the name of the group
If you answered "No, there is not one in my area," would you be interested in helping to start a group or in receiving information about the nearest city that has one?
Yes, interested in helping to start a group
Yes, receiving information about the nearest city that has one
None of the above
I acknowledge that the event will be recorded for Foundation use.
Yes
Submit
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