Involvement in MPE activities: registration for interested individuals Name* First Last Email* Country*AfghanistanAlbaniaAlgeriaAndorraAngolaAntigua & DepsArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia HerzegovinaBotswanaBrazilBruneiBulgariaBurkinaBurundiCambodiaCameroonCanadaCape VerdeCentral African RepChadChileChinaColombiaComorosCongoCongo {Democratic Rep}Costa RicaCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambiaGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIreland {Republic}IsraelItalyIvory CoastJamaicaJapanJordanKazakhstanKenyaKiribatiKorea NorthKorea SouthKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmar, {Burma}NamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussian FederationRwandaSt Kitts & NevisSt LuciaSaint Vincent & the GrenadinesSamoaSan MarinoSao Tome & PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth SudanSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamYemenZambiaZimbabweI am (check all that apply)* Myeloma patient AL amyloidosis patient Carer Healthcare Professional Other *Please tell us more below – if you have specific background or skills in areas such as medical writing, graphic design or other ways in which you’d like to help MPE, please tell us more about this! Interest in MPE activitiesAreas of interest (check all that apply)* Surveys around treatments, trials or around patient preferences Reviewing materials designed for patients Developing materials designed for patients Workgroups, tasks or activities relating to Patient Engagement Workgroup, tasks or activities relating to Clinical Research & Development Workgroup, tasks or activities relating to Access to clinical trials and treatment Myeloma Community Advisory Board Other Patient Councils, Advisory Boards or Panels Patient representation in EMA drug approval processes MPE Advocate Development Programme MPE workshops, events and conferences Other ways – I have other skills I would like to contribute! *Please, please tell us more below Do you have any prior experience in these areas?Please indicate all that apply (experience is absolutely not essential!) Surveys around treatments, trials or around patient preferences Reviewing materials designed for patients Developing materials designed for patients Workgroups, tasks or activities relating to Patient Engagement Workgroup, tasks or activities relating to Clinical Research & Development Workgroup, tasks or activities relating to Access to clinical trials and treatment Myeloma Community Advisory Board Other Patient Councils, Advisory Boards or Panels Patient representation in EMA drug approval processes MPE Advocate Development Programme MPE workshops, events and conferences Subscribe to our newsletter to stay informed on MPE news and activities?* Yes. Sign me up! No, not right now Click here to subscribe to our newsletter* I have read and I accept the privacy policy Our privacy policy tells you how we manage your submitted data.CAPTCHA
