Attend an Event

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*First Name

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*Last Name

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*Email Address

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*ZIP Code

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*I am a...

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*Are you bringing a guest? Only one guest per registrant, please.

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Additional information

Do you have any dietary restrictions? Select all that apply. (optional)

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How did you hear about this program? (optional)

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What do you hope to gain from this event? Select all that apply. (optional)

Basic education about NMOSD

A community of other patients/caregivers

Insight on the importance of talking with a doctor about NMOSD

I may be interested in becoming a speaker

Details about a management option for adults with anti-AQP4 antibody-positive NMOSD

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I'd like to receive text message reminders for this event (optional)

Phone Number

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By providing your phone number, you consent to receive text messages from Alexion regarding reminders and updates about the upcoming event. Please note that standard messaging and data rates may apply. You can opt-out of receiving messages at any time by replying "STOP."

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By checking this box and submitting this form, I can confirm and agree to the following:

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If I have NMOSD or care for someone who does, I confirm I am 18 years of age or older.
If I care for someone living with NMOSD, I confirm this person is also at least 18 years of age.
I am giving Alexion permission to provide promotional information to me or otherwise contact me about Alexion products, services, programs, or other topics that Alexion thinks may interest me. I have read and understand the Alexion Privacy Notice.

For more information on how your information may be used, please review Alexion’s Privacy Notice.

Connecting patients, caregivers, and doctors in the NMOSD community

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