The Vascular Birthmarks Foundation Dr. Linda Rozell-Shannon, PhD President and Founder

Patients and families can use this form to register for the VBF iTEAM Conference in Athens, Greece on June 7-8, 2019. Registration for Families is FREE, and free laser treatment and dental exams are available to those who qualify. Patients and families can submit the form below to register, and contact us with any questions. We look forward to seeing your family in Greece!

Read more about the Conference on the VBF Greece Conference Information Page

Medical Professionals can find out more and register for the conference here. Note that only families and patients may register using this form.
Registrant Information

Registrant Information

 
 
 
Greece conference Patient

Patient Information

 
Patient's Birthmark Info

Vascular Birthmark Information

Upload a photo showing ​the patient's vascular ​birthmark. Photos are required and will be used to determine eligibility for free laser treatment and dental exams, and also to assign patients to the appropriate clinics. Your photos will be shared with our VBF Experts and others for these purposes.
PATIENT REQUESTS

Preferences

 
 
 
ACCOMPANYING PEOPLE

Accompanying People

Please fill out all fields for anyone accompanying you and the patient to the Conference. Only include people other than the patient and the registrant. Registrations are limited to four people in total, including the registrant and the patient.
Person 1 Info
 
 
Person 2 Info