Where

This is an online event.

Contact

Sue Martin, Executive Director
Bleeding Disorders Association of South Carolina
864-350-9941
info@hemophiliasc.org

Virtual Innovation Program (VIP) Application

Please fill out the following application information to be considered for approval to the VIP. You will be contacted by the Chapter for approval as funding to this innovative program is secured for access opportunity. Thank you!

* Required information

Personal Information

  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • *
  • Are you a member of Hemophilia of South Carolina!

Business Information

Accommodations & Education Information

  • *

    BDASC would like to know if you have the following in your household.

  • If enrolled in the program, I will sign and send in the Device Policy signature page and comply with the policy content.

  • I will fill out the VIP Surveys about the program as requested from time to time.

  • I will visit the VIP informational links and apps when loaded on to the IPad.

  • I will be responsive and involved within the chapter and attend virtual events with my device as I am available to do so.

  • I attest to the above statements being true.


Yes, I would like to receive your email newsletters

Register