1. Survey for Participants - Help us to understand the audience needs

Thank you for expressing interest in attending Webinar 009, run by Putting Rare Diseases Patients First!(R).  So that we can understand the potential audience it would be helpful if you could respond to the following questions. The information will be treated in strictest confidence and will never be shared with other organizations or groups.  GoToMeeting login information will be sent to you so that you can take part in the Webinar.   This is a Webinar intended for rare disease patients and parents with children who have rare diseases. They do not have to pay to take part.  If you are a professional advocate, and would like to take part in this Webinar, we are requesting that you donate a minimum of 5 USD for your participation in this Webinar.

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* 2. What is your First Name?

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* 3. What is your surname?

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* 4. What is your gender?

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* 5. Enter the Email address for the GoToMeeting login information to be sent to.

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* 6. Do you yourself have a rare disease?

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* 7. Does your child have a rare disease?

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* 8. Are you a professional patient advocate for patients with rare diseases?  If you are a professional patient advocate, please make a donation of 5 USD at the website www.prdpf.org under Donate.

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* 9. Why is this Webinar of interest to you?

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* 10. Would you like to receive updates about other PRDPF! Webinars?

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* 11. How did you find out about this Webinar?

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* 12. Would the organization that you represent be interested in sponsoring this Webinar? Sponsorship levels start from 250 USD for a lifetime mention on the PRDPF! website.

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