Join HAEA
Join the HAEA - It's Free!
Become a member today and receive current disease information on HAE and FDA-approved HAE treatments. It's free and your privacy is protected.

Your membership includes:
  • Peer-to-peer support from our Patient Advocates Team
  • HAEA in Action monthly newsletter
  • Press releases and news alerts
  • Access to the HAEA CafĂ© - online communications platform
  • Patient conference announcements
  • Facebook closed group membership
  • A warm welcome into a supportive community of HAE patients and families across the US


Having trouble filling out the form? If so, call us at (866) 798-5598 and we'll be happy to register you as a member over the phone.

First Name: 
Last Name: 
 
Address: 
 
 
City: 
State:    Zip Code: 
 
Telephone Number: 
E-mail address: 
Date of Birth: 
 
Angioedema Type: 
 
Insurance Company: 
Preferred Hospital for Emergencies: 
 
Physician Who Treats you for HAE: 
Physician's Specialty: 
Is your doctor knowledgeable about HAE? 
 

Physician's Address: 
 
 
City: 
State:    Zip Code: 
 
Physician's Telephone Number: 
 

Attacks Per Year: 
 
Number of Family Members with HAE: 
(not including yourself) 
 
Are you Interested in Participating
in a Clinical Trial? 

Please enter any questions or comments here: