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Asthma Society Sign Up Information

Last Updated:
3/2/2020 9
Site Encrypted:
Yes
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Email Verified:
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Data Held

Email Address

 Email

Username

 

Your Name

 First Name, Last Name

Your Address

 Home Address, City, Country

Phone Number

 Phone

Post-Registration Data

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Validation

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Membership Emails

Below is a sample of the emails you can expect to receive when signed up to Asthma Society.

Hello Guide!

We're glad you're here,

Activate Account

(Just confirming you're you.)


helloguide GmbH
Benzweg 5, 64293 Darmstadt, Germany
Terms of Use ? Privacy Policy

Registration
I'm a Patient / Parent of someone with asthma
First name
Last name
Title
Username
Email
Phone
Home address
City
Country
Gender
I'm a Patient / Parent of someone with asthma
Form Selector *
I'm a Healthcare professional
I'm a Patient / Parent of someone with asthma
Male
Gender *
Female
Male
How did you hear about us? *
- Select a value -
How did you hear about us? *
- Select a value -
Which sector do you work in? *
- Select a value -
Yes
If you are registered as a GP please enter your unique 5 digit registration number, with no spaces. Are you over 18?
Country *
- Select a value -
City / County *
- Select a value -
Post
We need your phone number to keep in touch with you about our campaigns and events. Please enter your number without +, (), or spaces. I would like to receive occasional updates from the Asthma Society of Ireland including Asthma News, the Asthma Society E-Zine, details of Asthma Clinics in my area and details of other events or campaigns by: Contact me by
Email
Post
Phone
Email
SMS
Phone
I am a parent/carer of a child with asthma and would like to join the Asthma Parent Programme, and receive tailored updates and tips on managing asthma in children.
SMS Parent Program
My practice has signed up for the Free GP Care for Under 6's Programme
I am a parent/carer of a child with asthma and would like to join the Asthma Parent Programme, and receive tailored updates and tips on managing asthma in children. Under 6 Program
I have read the privacy policy *
My practice has signed up for the Free GP Care for Under 6's Programme NOTE: Free membership of the Society does not confer voting rights. Click here to view the ASI privacy policy.
Data Name Data Type Options
I'm a Patient / Parent of someone with asthma   Text Box
First name   Text Box
Last name   Text Box
Title   Text Box
Username   Text Box
Email   Text Box
Phone   Text Box
Home address   Text Box
City   Text Box
Country   Text Box
Gender   Text Box
I'm a Patient / Parent of someone with asthma   option Form Selector *
I'm a Healthcare professional   option I'm a Patient / Parent of someone with asthma
Male   option Gender *
Female   option Male
How did you hear about us? *   dropdown - Select a value -
How did you hear about us? *   dropdown - Select a value -
Which sector do you work in? *   dropdown - Select a value -
Yes   checklist If you are registered as a GP please enter your unique 5 digit registration number, with no spaces. Are you over 18?
Country *   dropdown - Select a value -
City / County *   dropdown - Select a value -
Post   checklist We need your phone number to keep in touch with you about our campaigns and events. Please enter your number without +, (), or spaces. I would like to receive occasional updates from the Asthma Society of Ireland including Asthma News, the Asthma Society E-Zine, details of Asthma Clinics in my area and details of other events or campaigns by: Contact me by
Email   checklist Post
Phone   checklist Email
SMS   checklist Phone
I am a parent/carer of a child with asthma and would like to join the Asthma Parent Programme, and receive tailored updates and tips on managing asthma in children.   checklist SMS Parent Program
My practice has signed up for the Free GP Care for Under 6's Programme   checklist I am a parent/carer of a child with asthma and would like to join the Asthma Parent Programme, and receive tailored updates and tips on managing asthma in children. Under 6 Program
I have read the privacy policy *   checklist My practice has signed up for the Free GP Care for Under 6's Programme NOTE: Free membership of the Society does not confer voting rights. Click here to view the ASI privacy policy.

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Comment on: 01/09/2020