Database of Pulmonary Hypertension in South Africa


Registration

Please note that we only support the following countries: South Africa, Botswana, Lesotho, Madagascar, Mauritius, Mozambique, Namibia, Swaziland and Zimbabwe. Please email PHA@PHAssociation.org to get in touch with your closest supporting association.

Since a consolidated database for Pulmonary Hypertension does not currently exist in South Africa, we would appreciate it if Patients, Caregivers and Medical Professionals would be so kind as to REGISTER for FREE so that we can create a database of all current patients. In doing so, we will have strength in numbers, so that we can work together as a community for the benefit of all those affected by Pulmonary Hypertension.

To register, please complete the form.

Patient Registration Form

Patient Information

Physical Address

We would like to send you and Envelope of Hope containing more information.


How did you hear about us?

What are your reasons for registering with us?

Symptoms

Is the patient treated by any of the below specialists?

Does the patient receive any of the below auxilliary services?*

Would you like to get involved with our activities?



Caregiver/Family Member

Physical Address


Patient Information

Would you like to get involved with our activities?



Healthcare Professional

Physical Address


Would you like to get involved with our activities?


Stakeholder / Interested member of the public

Physical Address

Would you like to get involved with our activities?



Friends of PHA.SA