Become a Member

For 30 years, the Midwest Hemophilia Association has been committed to empowering individuals and families in Kansas and western Missouri with bleeding disorders. You can be part of the MHA family by becoming a member today.

As a member you will receive:

Chapter Factors Newsletter
Invitations to educational events
Camp Information
Call For Action Advocacy Alerts

Member Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Phone*
Email*
Household members
Other Adult(s) or Children in Household (if applicable) First Name Last Name Date Of Birth Diagnosis (Hemophilia A, Hemophilia B, VWD, Other, N/A)
Affected Bleeding Disorder
- Hemophilia A
- Hemophilia B
- Von Willebrand disease (VWD)
- Other
Language Spoken at home?
Please enter what language is spoken at home?
MHA Membership Type
- Individual/Family
I want to help build our community with a contribution.
Payment
- Pay online with PayPal
Membership Total
$0.00

Because of you, we will continue to do great things for bleeding disorders!

Other Adult(s) or Children in Household (if applicable)	First Name	Last Name	Date Of Birth	Diagnosis (Hemophilia A, Hemophilia B, VWD, Other, N/A)