NENHF Consent to Contact Form
By completing this form, you are authorizing The University of Nebraska Medical Center Hemophilia Treatment Center and/or Children’s Hospital to release your contact information to NENHF and to be added to our mail and email correspondence lists. NENHF will contact you by phone or email in order to obtain any additional information that may be relevant for determining program interest and eligibility. Your participation is completely voluntary and can be withdrawn at any time upon your request. Your information will not be used for any other purpose or released to any other parties.