myITPteam

Thank You for Your Interest in the myITPteam Beta Program

Thank you for your interest in joining the myITPteam private beta, a social network for those living with immune thrombocytopenia. The purpose of this short survey is to learn more about your life with ITP. We will be in touch over the coming months for additional feedback as we build out features for myITPteam.

ALL OF YOUR ANSWERS TO THIS SURVEY WILL BE KEPT COMPLETELY CONFIDENTIAL.

Question Title

* 1. Please enter your information below and we will let you know when the site launches!
(We will not share your information. The information you provide below is completely confidential).

First name:

City/Town:

State/Province:

Country:

Email Address: *

Question Title

* 2. What best describes you below?

I am living with immune thrombocytopenia, but I'm not treating it.

I am living with immune thrombocytopenia, and I'm treating it.

I care for someone living with immune thrombocytopenia.

Other (Please specify what best describes you.)

Question Title

* 1. Please enter your information below and we will let you know when the site launches! (We will not share your information. The information you provide below is completely confidential).

Question Title

* 2. What best describes you below?

* 1. Please enter your information below and we will let you know when the site launches!
(We will not share your information. The information you provide below is completely confidential).