Pediatric Pituitary Day

Join experts from Duke Children's and WakeMed Children's of Raleigh, and
The University of North Carolina at Chapel Hill for:

An Education & Awareness Event for
Families of Children with Hypopituitarism

Benefiting:

Saturday, October 5, 2019

8:30 AM to 3:30 PM

Cost: $30
(continental breakfast & lunch are included)

Duke Clinical Research Institute
200 Morris Street
Durham, NC 27701

The goal of this meeting is to educate families to improve the care and understanding of hypopituitarism and its effects and to connect families with the experts and each other to provide better care for our loved ones to thrive with hypopituitarism.

For questions, contact Lindsay.Singler@Duke.edu

Contact Information

First Name *

Last Name *

Street Address *

City *

State *

Zip Code *

Phone Number *

Email Address *

Registration

You will not receive a ticket for the event; however, your name will be added to the attendee list after you register. On the day of the event, please show up at Duke and check-in at the registration desk

Number of people attending *

1st Attendee

Please list first and last name for 1st attendee

Does this attendee have any dietary restrictions?

No

Yes (please list) Yes (please list)

Please describe your affiliation with hypopituitarism (mark all that apply)

I am a patient with hypopituitarism or a different endocrine condition

I am a parent to a patient with hypopituitarism

I am a grandparent or other family member to a patient with hypopituitarism

I am a health care provider

Other - please specify different endocrine disorder Other - please specify different endocrine disorder

2nd Attendee

Please list first and last name for 2nd attendee

Does this attendee have any dietary restrictions?

No

Yes (please list) Yes (please list)

Please describe your affiliation with hypopituitarism (mark all that apply)

I am a patient with hypopituitarism or a different endocrine condition

I am a parent to a patient with hypopituitarism

I am a grandparent or other family member to a patient with hypopituitarism

I am a health care provider

Other - please specify different endocrine disorder Other - please specify different endocrine disorder

3rd Attendee

Please list first and last name for 3rd attendee

Does this attendee have any dietary restrictions?

No

Yes (please list) Yes (please list)

Please describe your affiliation with hypopituitarism (mark all that apply)

I am a patient with hypopituitarism or a different endocrine condition

I am a parent to a patient with hypopituitarism

I am a grandparent or other family member to a patient with hypopituitarism

I am a health care provider

Other - please specify different endocrine disorder Other - please specify different endocrine disorder

4th Attendee

Please list first and last name for 4th attendee

Does this attendee have any dietary restrictions?

No

Yes (please list) Yes (please list)

Please describe your affiliation with hypopituitarism (mark all that apply)

I am a patient with hypopituitarism or a different endocrine condition

I am a parent to a patient with hypopituitarism

I am a grandparent or other family member to a patient with hypopituitarism

I am a health care provider

Other - please specify different endocrine disorder Other - please specify different endocrine disorder

Donations

I am unable to attend but would love to support this program with a donation to The MAGIC Foundation.

Current Total:

$0.00

Pediatric Pituitary Day

Join experts from Duke Children's and WakeMed Children's of Raleigh, and The University of North Carolina at Chapel Hill for: An Education & Awareness Event for Families of Children with Hypopituitarism

Benefiting:

Contact Information

Registration

Donations

Join experts from Duke Children's and WakeMed Children's of Raleigh, and
The University of North Carolina at Chapel Hill for:

An Education & Awareness Event for
Families of Children with Hypopituitarism