Involvement in EMA activities: registration for interested individuals

Personal Details

• First Name
  Last Name
  
• Nationality
  Country of Residence
  
• Phone
  Email Address
  
• Education (Optional)
  Languages Spoken
  

Representation

• PatientConsumerCarerHealthcare Professional*AcademiaOther

*An institutional email address must be provided

Membership/Affiliation

• Organisation
  To select an "EMA eligible" organisation, click here [+]
  None AGE Platform Europe (AGE) Alzheimer Europe (AE) Association of European Cancer Leagues (ECL) Biomedical Alliance in Europe (BioMedAlliance) Council of European Dentists (CED) EGAN - Patients' Network for Medical Research and Health (EGAN) Europa Uomo (EUomo) European Academy of Allergy and Clinical Immunology (EAACI) European Academy of Neurology (EAN) European Academy of Paediatrics (EAP) European AIDS Treatment Group e.V. (EATG) European Alliance for Vision Research and Ophthalmology (EUEYE) European Alliance of Associations for Rheumatology (EULAR) European Association for Clinical Pharmacology and Therapeutics (EACPT) European Association for the Study of Diabetes e.V. (EASD) European Association for the Study of the Liver (EASL) European Association of Hospital Pharmacists (EAHP) European Association of Nuclear Medicine (EANM) European Association of Urology (EAU) European College of Neuropsychopharmacology (ECNP) European Committee for Treatment and Research in Multiples Sclerosis (ECTRIMS) European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) European Federation of internal Medicine (EFIM) European Federation of Neurological Associations (EFNA) European Forum for Primary Care (EFPC) European Foundation for the Care of Newborn Infants (EFCNI) European Geriatric Medicine Society (EuGMS) European Haemophilia Consortium (EHC) European Headache Federation (EHF) European Heart Network (EHN) European Hematology Association (EHA) European Idiopathic Pulmonary Fibrosis & Related Disorders Federation (EU-IPFF) European Institute of Women's Health (EIWH) European Liver Patients' Association (ELPA) European Lung Foundation (ELF) European Multiple Endocrine Neoplasia Alliance (EMENA) European Multiple Sclerosis Platform (aisbl) (EMSP) European Organisation for Rare Diseases (EURORDIS) European Organisation for Research and Treatment of Cancer (EORTC) European Patients' Forum (EPF) European Psychiatric Association (EPA) European Public Health Association (EUPHA) European Pulmonary Hypertension Association (PHA EUROPE) European Respiratory Society (ERS) European Society for Medical Oncology (ESMO) European Society for Organ Transplantation (ESOT) European Society of Cardiology (ESC) European Society of Contraception and Reproductive Health (ESCrh) European Society of Endocrinology (ESE) European Society of Oncology Pharmacy (ESOP) European Society of Radiology (ESR) European Specialist Nurses Organisation (ESNO) European Union of General Practitioners (UEMO) Fabry International Network (FIN) Fédération Internationale du Diabète Région Europe (IDF Europe) Global Alliance Mental Illness Advocacy Networks - Europe (GAMIAN-Europe) Health Action International Europe (HAI ) Health Care Without Harm Europe AISBL (HCWH Europe) International Alliance of Dermatology Patient Organizations (GlobalSkin) International Alliance of Patients' Organizations (IAPO) International Bureau for Epilepsy (IBE) International Gaucher Alliance (IGA) International League Against Epilepsy (ILAE) International Patient Organisation for Primary Immunodeficiencies (IPOPI) International Prader-Willi Syndrome Organisation (IPWSO) Lupus Europe (LUPUS EUROPE) Lymphoma Coalition Europe (LCE) Myeloma Patients Europe (MPE) Pain Alliance Europe (PAE) Parkinson's Europe (EPDA) Pharmaceutical Group of the European Union (PGEU) Spinal Muscular Atrophy Europe (SMA Europe) Standing Committee of European Doctors (CPME) Thalassaemia International Federation (TIF) The European Consumer Organisation (BEUC) The European Huntington Association (EHA) United European Gastroenterology (UEG) United Parent Projects Muscular Dystrophy (World Duchenne Organization) (UPPMD)

Interest In EMA Activities

Prior participation in EMA (if yes, please specify)

Disease / Condition Area(s) Of Interest (please indicate below)

• Addiction [+]

  	Alcohol
  	Opioids
  	Other:

• Allergies [+]

  	Active Substances (e.g. penicillin)
  	Allergic Rhinitis
  	Animal Fur, Skin or Saliva
  	Environmental
  	Food (milk, soy, eggs, gluten, peanuts, tree nuts, fish…)
  	Toxins
  	Other:

• Cancer [+]

  	Brain and CNS
  	Breast
  	Bone
  	Cancer of Unknown Primary
  	Paediatric Cancers
  	Gastrointestinal
  	- Colorectal
  	- Gastric
  	- Liver
  	- Oesophageal
  	- Pancreas
  	Gynaecologic
  	- Cervical
  	- Endometrial
  	- Ovarian
  	Head and Neck
  	Haematological
  	- Acute Leukaemias
  	- Chronic Leukaemias
  	- Lymphomas
  	- Myelodysplastic Syndromes
  	- Myeloproliferative Disorders
  	- Myeloma
  	Lung
  	Skin
  	Soft Tissue Sarcoma
  	Thyroid
  	Urological Cancers
  	- Bladder
  	- Kidney
  	- Prostate
  	- Testicular
  	Other:

• Cardiovascular (heart) diseases [+]

  	Aortic Aneurysms
  	Arrhythmias
  	Atherosclerosis
  	Cardiomyopathy
  	Congenital Heart Disease
  	Coronary Heart Disease
  	Heart Failure
  	Heart Valve Disease
  	Hypertension
  	Peripheral Artery Disease
  	Venous Thromboembolism (VTE)
  	Other:

• Dermatological (skin) diseases [+]

  	Acne
  	Burns
  	Eczema
  	Epidermolysis Bullosa
  	Lupus
  	Psoriasis
  	Scleroderma/Systemic Sclerosis
  	Vitiligo
  	Wounds
  	Other:

• Dental

• Diabetes [+]

  	Diabetes, Type I
  	Diabetes, Type II
  	Other:

• Ear, nose and throat diseases [+]

  	Adenoiditis
  	Facial Paralysis
  	Other:

• Endrocrinological (hormone) diseases [+]

  	Acromegaly
  	Adrenal Insufficiency (Addison disease)
  	Cushing’s Disease
  	Diabetes
  	Growth Hormone Deficiency
  	Hyperthyroidism
  	Hypothyroidism
  	Osteoporosis
  	Other Pituitary Disorders
  	Other:

• Gastrointestinal diseases [+]

  	Coeliac Disease
  	Crohn's Disease
  	Gastritis
  	Oesophagitis
  	Pancreatitis
  	Peptic Ulcer
  	Ulcerative Colitis
  	Other:

• Genetic diseases (including metabolic) [+]

  	Alkaptonuria (AKU)
  	Cystic Fibrosis
  	Down's Syndrome
  	Fabry Disease
  	Gaucher Disease
  	Hemochromatosis
  	Hunter (MPS II)
  	Klinefelter Disease
  	Mitochondrial
  	Morquio Syndrome (MPS IV)
  	Phenylketonuria (PKU)
  	Pompe Disease
  	Porphyria
  	Rett Syndrome
  	Sanfilippo Syndrome (MPS III)
  	Sickle Cell Anaemia
  	Tay-Sach’s Disease
  	Thalassaemia
  	Urea Cycle Disorder
  	Other:

• Gynaecological diseases [+]

  	Endometriosis
  	Female Infertility
  	Other:

• HIV/AIDS

• Haematological (blood) diseases [+]

  	Anaemia
  	Autoimmune Haemolytic Anaemia
  	Coagulation Disorders
  	Haemoglobinopathies
  	Haematological Cancers
  	- Acute Leukaemias
  	- Chronic Leukaemias
  	- Lymphomas
  	- Myelodysplastic Syndrome
  	- Myeloproliferative Disorders
  	- Myeloma
  	Sickle Cell Anaemia
  	Thalassaemia
  	Other:

• Immune (including auto-immune) diseases [+]

  	Addison’s Disease
  	Autoimmune Haemolytic Anaemia
  	Autoimmune Hepatitis
  	Crohn's Disease
  	Glomerulonephritis
  	Granulomatosis with Polyangiitis (Wegener’s)
  	Grave’s Disease
  	Guillain-Barré Syndrome
  	Hashimoto’s Thyroiditis
  	HIV/AIDS
  	Kawasaki Disease
  	Lupus
  	Myasthenia Gravis
  	Primary Biliary Cirrhosis
  	Psoriasis
  	Pulmonary Fibrosis
  	Scleroderma/Systemic Sclerosis
  	Sjogren’s Syndrome
  	Wiskott-Aldrich Syndrome (WAS)
  	Other:

• Infectious diseases (non-viral) [+]

  	Bacterial Infections
  	Malaria
  	Sexually Transmitted Diseases
  	Tuberculosis
  	Other:

• Infectious diseases (viral) [+]

  	Ebola
  	Hepatitis A
  	Hepatitis B
  	Hepatitis C
  	HIV/AIDS
  	Influenza (Flu)
  	Sexually Transmitted Diseases (STD)
  	Other:

• Liver diseases [+]

  	Biliary Tract Disorders
  	Cirrhosis
  	Hepatitis A
  	Hepatitis B
  	Hepatitis C
  	Haemochromatosis
  	Porphyria
  	Other:

• Male urogenital [+]

  	Erectile Dysfunction
  	Male Infertility
  	Priapism
  	Other:

• Neurological (nervous system) diseases [+]

  	Amytrophic Lateral Sclerosis (ALS)
  	Alzheimer's Disease
  	Epilepsy
  	Friedreich's Ataxia
  	Guillain-Barré Syndrome
  	Huntington’s Disease
  	Migraine
  	Multiple Sclerosis
  	Muscular Dystrophies
  	Parkinson's Disease
  	Peripheral Neuropathy
  	Restless Leg Syndrome
  	Other:

• Nutritional diseases [+]

  	Anorexia Nervosa
  	Bulimia Nervosa
  	Coeliac Disease
  	Obesity
  	Other:

• Ophthalmological (eye) diseases [+]

  	Corneal Disease
  	Glaucoma
  	Macular Degeneration
  	Retinal Disease
  	Stargardt's Disease
  	Uveitis
  	Other:

• Pain management [+]

  	Arthritis
  	Fibromyalgia
  	Migraine
  	Rheumatoid Arthritis
  	Other:

• Psychiatric disorders [+]

  	Attention Deficit Disorder (ADD)
  	Attention Deficit- Hyperactivity Disease (ADHD)
  	Bipolar Disorder
  	Depression
  	Schizophrenia
  	Other:

• Respiratory diseases [+]

  	Acute Respiratory Distress Syndrome (ARDS)
  	Allergic Rhinitis
  	Asthma
  	Chronic Obstructive Pulmonary Disease (COPD)
  	Cystic Fibrosis
  	Mesothelioma
  	Pulmonary Fibrosis
  	Pulmonary Hypertension
  	Sarcoidosis
  	Tuberculosis
  	Other:

• Rheumatological diseases [+]

  	Crohn’s Disease
  	Fibromyalgia
  	Granulomatosis with Polyangiitis (Wegener’s)
  	Juvenile Arthritis
  	Lupus
  	Osteoarthritis
  	Psoriasis
  	Rheumatoid Arthritis
  	Scleroderma
  	Ulcerative Colitis
  	Other:

• Transplantation [+]

  	Graft versus Host Disease
  	Heart Transplant
  	Kidney Transplant
  	Lung Transplant
  	Pancreas Transplant
  	Stem Cell Transplant
  	Other:

Data Protection

• The European Medicines Agency processes your personal data in accordance with Regulation (EU) 2018/1725 on the protection of natural persons with regard to the processing of personal data by the Union institutions, bodies, offices and agencies and on the free movement of such data.
  The Controller of your data is the Head of Stakeholder and Communication Division who may be contacted through the Public Engagement Department at S-DataController@ema.europa.eu. The information that you provide will be used only for the purpose of informing and involving patients and other interested parties in the regulatory activities of EMA. You will be asked on an annual basis if you wish to remain in the database, and to ensure your contact details and interests are up to date. Removal from the database can also be requested at any time by email to: StakeholdersDB@ema.europa.eu.
  Further information on how your personal data is processed is provided in the specific privacy statement for this database published on EMA website: https://www.ema.europa.eu/en/documents/other/privacy-statement-ema-individual-experts-stakeholder-database_en.pdf.

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