Community Outreach Program: Topeka – Factor Up Topeka!

Knowledge is power and education is the key that unlocks that power! Join us for an education dinner program at the Blue Moose in Topeka, Kansas–followed by an escape room experience at the Keynondrum Escape Room!

FIRST, learn about the importance of Factor VIII levels and what a first-in-class treatment could mean for your management plan. This program will feature a healthcare provider and a patient living with Hemophilia A. It is presented by Sanofi’s CoRe Manager, Kyrie Smith. Includes a complimentary dinner.

THEN…CAN YOU ESCAPE? Keynundrum is a thrilling game of knowledge, creativity, & teamwork where we will put our skills to the test!

Must RSVP by August 2, 2024. The program is Hemophilia A-focused, but all bleeding disorders are welcome to attend.

Official Sanofi Invitation

Community Outreach Program August 8, 2024

Adults Attending:*
Click the PLUS sign next to the box to add more. Diagnosis examples: Hemophilia A, Hemophilia B, von Willibrands, Carrier, Other, N/A
First Name Last Name Date of Birth Diagnosis
Kids attending:
Click the PLUS sign next to the box to add more. Diagnosis examples: Hemophilia A, Hemophilia B, von Willibrands, Carrier, Other, N/A
First Name Last Name Date of Birth Diagnosis
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email
Are you employed by a specialty pharmacy or product manufacturer?*
- No, I am not employed by a specialty or product manufacturer. .
- Yes, I am employed by a specialty pharmacy or product manufacturer.
Photo Consent Opt Out -From time to time, the Midwest Hemophilia Association (MHA) will want to use pictures and/or videos from our events to promote bleeding disorder programs and MHA's activities. Please check the box below if you would NOT like to grant permission to be able to use your image or those who have registered for that purpose.
- Yes I DO consent to the use of pictures of videos.
- No I do NOT consent to the use of pictures of videos.
Have ever experienced an inhibitor?
- Yes, I/we have or have had an inhibitor.
- No, I/we have not had an inhibitor.

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Date
Date(s) - August 8 2024 at 6:00 PM - 8:30 PM

Location
Blue Moose

Category(ies)

First Name	Last Name	Date of Birth	Diagnosis

First Name	Last Name	Date of Birth	Diagnosis