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Alopecia Areata Patient Education Program
April 23, 2026 | 4:00–8:00 PM
Mount Sinai Goldwurm Auditorium
1.
Will you be attending the Alopecia Areata Patient Educational Program?
Yes
*
2.
What is your first name?
(Required.)
*
3.
What is your last name?
(Required.)
4.
What is your email address?
*
5.
Please provide your organizational affiliation.
(Required.)
6.
Are you a:
Patient
MD
PHD
RESIDENT
STUDENT
Other (please specify)
*
7.
How many people will you be bringing aside from yourself?
(Required.)
0
1
2
3
More - please specify
8.
If you are bringing guests, what is their full name?
Current Progress,
0 of 8 answered