If you are a patient support group covering acute leukemias, please complete the form below to apply for membership.
Your organization
Is a patient organization?
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Is registered as non-profit, or is in the process of becoming a formally registered entity?
Has a permanent character?
Has specific activities on acute leukemias and on supporting leukemia patients?
Has leukemia patients or relatives of leukemia patients in its governing board or leadership?
Is willing and able to contribute to the work of the ALAN?
Which diseases does your organization deal with?
Acute leukemiaAdult acute leukemiaPediatric acute leukemiaAll blood cancersGeneral hematologyAll leukemia typesHodgkin lymphomaNon-Hodgkin lymphomaAcute lymphoblastic leukemiaAcute myeloid leukemiaChronic lymphocytic leukemiaChronic myeloid leukemiaMultiple Myeloma
Other
Which of the following do you provide?
InformationHelplinesupport groupswebsitePatient/family daysPatient advocacy in research
Are you a member of:
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