Advocacy Engagement Form

Are you interested in the policy and advocacy activities of ESE ? Would you like to have your voice heard in EU health policy matters ? Would you like to obtain more information and/or engage in these activities ? Please complete the below form and submit.

Name *

National Society *

Hospital Affiliation *

Country *

Email *

Is interested to be involved in ESE’s activities on Policy and Advocacy in the following area’s *

COVID 19 and the EU4 Health Programme
The EU Beating Cancer Plan
Rare Diseases and Health Inequalities
Endocrine Disrupting Chemicals

Has the following specific question

Is interested to be contacted by ESE's Policy & Advocacy lead (Dirk de Rijdt) to discuss further?

Yes
No

If yes, please indicate the referred date and time that will be confirmed to you by email

The data that you submit via this form will be used in order to record your interest in policy area topics in order to provide engagement opportunities with ESE's expert groups and Policy and Advocacy work. Your data will be made available to relevant ESE Committees (eg, the Policy and Advocacy Task Force). The data that you submit via this form will be stored securely in accordance with ESE’s Privacy Policy and will not be shared with any third parties. Your data will be fully accessible upon request and you can unsubscribe from the mailing list at any time by emailing info@ese-hormones.org. Please confirm you have read and agree to the above data policy *

Agree

Advocacy Engagement Form

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