Be An Advocate - National Alopecia Areata Foundation

Be An Advocate

Your information will be forwarded to Communications Director, Gary Sherwood, who will contact you when we have a legislative call-to-action in which we ask our community to reach out to their representatives or senators. If you’re interested in learning more about becoming a Legislative Liaison or, if you’re between the ages 12-17, a Legislative Mentor, please email Gary at gary@naaf.org.

"*" indicates required fields

Name*

First Last

Email*

Address*

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

Phone

Date of birth*

Gender*

Relation to Alopecia Areata? (Check all that apply)

I have alopecia areata

My child has alopecia areata

My spouse/partner/other family member has alopecia areata

I am a healthcare provider

I am a researcher

Other

Comments

This field is for validation purposes and should be left unchanged.