Bringing expert education and important conversations to the atypical-HUS community

This program is sponsored by Alexion Pharmaceuticals, Inc.

Please note, these programs are intended for US Patients and Caregivers only. For information on Alexion programs for healthcare professionals, please contact us.

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Select the event you would like to register for* Wednesday, June 15, 2022, 7:00 PM - aHUS Together Wednesday, June 29, 2022, 7:00 PM - Tips and Tricks: Daily Living with atypical-HUS

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If you would like to receive a reminder phone call 2 business days prior to the webinar/live event, please include the best phone number to reach you in the box above and choose to receive a reminder call below.

Would you like to receive a reminder call prior to the event?* Yes No

Which best describes you?* An individual who may have atypical-HUS An individual diagnosed with atypical-HUS A family member or friend of someone who may have atypical-HUS A family member or friend of someone diagnosed with atypical-HUS A patient advocacy affiliate Other (please describe)

Which best describes your (or your loved one's) current treatment status? On prescription medication for my (their) atypical-HUS Not treating my (their) atypical-HUS with a prescription medication Not sure

Which best describes your (or your loved one's) enrollment status in Alexion's OneSource™ patient services program? Enrolled in Alexion's OneSource™ patient services program Not enrolled in Alexion's OneSource™ patient services program Not sure

What is your gender?* Male Female Non-binary Prefer not to answer

What is your age range?* 0-17 18-24 25-35 36-45 46-65 66+ Prefer not to answer

How long ago were you (or your loved one) diagnosed with atypical-HUS?* 0-6 months ago 7-11 months ago 1-5 years ago More than 5 years ago N/A

If you (or your loved one) are currently taking an Alexion medication for atypical-HUS, what is the treatment schedule? Every 4 or 8 weeks Every 2 weeks Not sure N/A

How did you hear about this program? Website Emailed Invitation Mailed Invitation Friend or Family Member OneSource™ Physician/Healthcare Provider Another Patient/Caregiver Alexion Patient Advocacy Group Eventbrite Patient Worthy Other (please describe)

EVENT PREFERENCES

If you are registering for a webinar, you can skip the next three questions.

Are you bringing a guest? (Only one guest per registrant) Yes No

Which best describes your guest? An individual who may have atypical-HUS An individual diagnosed with atypical-HUS A family member or friend of someone who may have atypical-HUS A family member or friend of someone diagnosed with atypical-HUS A patient advocacy affiliate Other (please describe)

Do you have any dietary restrictions? Vegetarian Vegan Gluten-Free Kosher

Do you grant permission for Alexion and those working on its behalf to contact you for feedback on the patient program?* Yes No

18 or older: By checking this box, I confirm I am 18 years of age or older. *

Use data for registration: I agree to my personal data being processed in this registration portal for the purposes of registering my interest in attending an upcoming patient program sponsored by Alexion. *

Opt-in: I give Alexion, or third-party companies working on behalf of Alexion, permission to contact me for marketing purposes, otherwise provide me with information about Alexion’s products, services, and programs or other topics of interest, conduct market research, or otherwise ask me about my experience with or thoughts about such topics in accordance with Alexion's Privacy Notice. Alexion will not sell or transfer my information to any unrelated third party for marketing purposes without my express permission. I understand that I can opt out of these communications at any time by contacting Alexion, as provided for on the communication.

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In order to register you for this program, we will need some personal information from you, such as your name, contact information and your relationship to atypical-HUS. We will use this information to register you for the program and contact you, should any changes to the program arise. We will not use your information for any other purpose without your consent and we do not, and will not, sell your personal information. To learn more, you can review Alexion’s Privacy Notice.