Mapping the needs of people living with extremely rare bleeding disorders and bleeding disorders of unknown cause (BDUC) in NMOs - Survey of European Haemophilia Consortium (EHC) for individuals

Identification

If you are a family member or a caregiver filling in this survey, please respond in consultation and on behalf of the person with a bleeding disorder that is in your care/ family.

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* 1. You are (please tick the relevant box):

A person with a bleeding disorder

A family member or a caregiver of a person with a bleeding disorder

Other (please specify)

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* 2. Please specify what is your bleeding disorder:

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* 3. Your country:

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* 4. Your age:

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* 5. Gender:

Male

Female

Other