Physician Login

Title

First Name*

Last Name*

Email*

City*

State/Region*

Country*

Institution or Organization Affiliation*
:

What is your primary specialty?*

Describe your role with Castleman disease (CD) patient care and/or research.*

On a PC computer, hold down the Ctrl key while clicking to select multiple descriptions. On a Mac, hold down the command key while clicking to select multiple descriptions.

Which Castleman disease subtypes do you treat and/or research?*

On a PC computer, hold down the Ctrl key while clicking to select multiple descriptions. On a Mac, hold down the command key while clicking to select multiple descriptions.

If you are a physician treating Castleman disease patients, are you interested in being listed on our physician referral list?*

Physician referral lists are given to Castleman disease patients in our community who are looking for physicians near them who are experienced with treating Castleman disease.

Are you employed by a pharmaceutical company?*

Additional Notes/Comments?

The CDCN values your privacy policy and will not share or sell your information with anyone else. By clicking Submit, you are voluntarily submitting your contact information and the above information.

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