Halifax Lymphoma Education and Support Meeting - November 21, 2018

Thank you for taking the time to register for the Halifax Lymphoma Patient and Caregiver Support Meeting on November 21, 2018

Full Name: *

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Email Address: *

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I have Hodgkin lymphoma

I have Follicular lymphoma

I have Diffuse Large B-Cell lymphoma

I have Marginal Zone/MALT lymphoma

I have Mantle Cell lymphoma

I have CLL/SLL lymphoma

I have Burkitt's lymphoma

I have Waldenstrom's Macroglobulinemia lymphoma

I have Transformed lymphoma

I have Peripheral T-Cell lymphoma

I have Cutaneous T-Cell lymphoma

I have NK-Cell lymphoma

I have another type of lymphoma, not listed here

I do not know what kind of lymphoma I have

I know someone who has lymphoma

Other

Other (please specify)

Yes

Not Sure