Porphyria Patient & Family Forum
June 27, 2026 at UT Southwestern Medical Center
Number of Attendees
Contact Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Type of Porphyria
*
Acute Intermittent Porphyria (AIP)
ALAD-Deficiency Porphyria (ADP)
Congenital Erythropoietic Porphyria (CEP)
Erythropoietic Protoporphyria (EPP)
Hepatoerythropoietic Porphyria (HEP)
Hereditary Coproporphyria (HCP)
Porphyria Cutanea Tarda (PCT)
Variegate Porphyria (VP)
X-Linked Protoporphyria (XLP)
Undiagnosed
Other
Relationship to porphyria
I have porphyria
My partner/spouse has porphyria
My child has porphyria
A family member or friend has porphyria
Other
Please provide the following details for each person in your group:
Rows
First Name
Last Name
Relationship to Porphyria
Guest #1
Has porphyria
Family/Friend has porphyria
Guest #2
Has porphyria
Family/Friend has porphyria
Guest #3
Has porphyria
Family/Friend has porphyria
Guest #4
Has porphyria
Family/Friend has porphyria
Yes, I would like to join the United Porphyrias Association to receive news, information and updates. UPA may also contact you for research opportunities related to porphyria and rare disease.
Agree
Submit
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