Skip to content
Understanding PH in Southeast Asia
Section 1: About you
Privacy Notice
By completing this survey, you agree to PVRI collecting and processing your personal data for the purpose of establishing a Southeast Asia PH Task Force. Your information will be used to analyse regional PH care gaps and, if you expressed interest, we may contact you regarding Task Force involvement. Your data will be stored securely and will not be shared with third parties without your explicit consent. You may withdraw your consent or request the deletion of your data at any time by contact us here:
pvrinstitute.org/about-us/contact-us
*
1.
What is your title?
(Required.)
*
2.
What is your first name?
(Required.)
*
3.
What is your surname?
(Required.)
*
4.
What is your work email address?
(Required.)
*
5.
What is your organisation / institution?
(Required.)
*
6.
While we recognise you may live and work in different locations, which Southeast Asian country are you most closely connected to?
(Required.)
Brunei Darussalam
Cambodia
Indonesia
Laos PDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
Vietnam
*
7.
What is your role?
(Required.)
Academic
Allied Health Professional
Career
Doctor
Patient
Patient advocate
Pharma/Industry
Policymaker
Researcher
Other – please specify
*
8.
What is your level of involvement in PH?
(Required.)
PH is my primary clinical/research focus
PH is part of my broader practice (e.g. General Cardiology/Pulmonology)
I have limited involvement but an interest in the field
Other - please specify
