ACARE Application

Center information

Center name(Required)

This information will be public

Clinic name

This information will be public

Center address(Required)

This information will be public

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Center email(Required)

This information will be public

Center phone

This information will be public

Center website

This information will be public

Department information

Department email address

This information will not be public

Department phone

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Department mail address

This information will not be public

Department head

Head of department name

This information will be public

Head of department email address

This information will not be public

Department deputy

Department deputy name

This information will be public

Department deputy email address

This information will not be public

Application

Dear Professor Markus Magerl,

I wish to join the Global Allergy and Asthma Excellence Network/HAEi Angioedema Centers of Reference and Excellence (ACARE) network and hereby apply for our center to become an ACARE.

Please explain why you want to become a Global Allergy and Asthma Excellence Network/HAEi Center:(Required)

My center is already a member of the following Global Allergy and Asthma Excellence Network COREs(Required)

UCARE

ADCARE

ANACARE

ARIACARE

None of the above

Please fill in the Power Point document "Center Presentation for Audit_PP template“, save it as a pdf file and upload it here. This presentation is mandatory for the application process and basis for the audit.(Required)

Download the presentation template here

Accepted file types: pdf, Max. file size: 100 MB.

Please note: Some of the information listed above (including the center’s name and address, contact information for patients, website and logo) may be published on the ACARE website. You can find examples of our centers' profiles on the "Centers" tab of the ACARE website: https://acare-network.com/centers

Verify information

Please verify your information before submitting your application. If you need to change your submitted information, click "Previous" at the bottom of this page to go back

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Applicant name(Required)

Applicant email(Required)

Application date(Required)

Applicant signature(Required)

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