Coalition of Skin Diseases Hill Day Registration Form

Please refer to this document for important information and guidelines on hotel, transportation, flights, reimbursements, etc.

For questions, please contact Natalie Mamerow and Nina Perez.

Name(Required)

First Last

Organization(Required)

State(Required)

Please list any special requests for your hotel room. We will do our best to accommodate all special requests; however, due to the limited number of rooms in our block, we cannot guarantee that all accommodation requests will be met.(Required)

Please list any dietary restrictions.(Required)

Select your t-shirt size.(Required)

I am willing to share photos and/or videos related to my patient story. I understand that CSD will follow up with me, and I give permission for CSD to use these materials on its website, social media, and other digital communications.(Required)

Yes

Coalition of Skin Diseases Hill Day Registration Form

Coalition of Skin Diseases

About Us

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Coalition of Skin Diseases Hill Day Registration Form

Coalition of Skin Diseases

About Us

Members

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It’s Time to Take Action!

It’s Time to
Take Action!