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Update Your Details

The information we ask for in your membership application plays a crucial role in shaping our advocacy work (e.g. access to treatment), the development educational resources for patient members and healthcare professionals, and community support activities in areas where people are located.

Accurate and up-to-date member profiles also help to inform and support research efforts that are vital to raising awareness and education around immunodeficiencies.

Our annual Update Your Details Campaign ensures that we have the most up to date data and information about our members.

To add or update your details, simply fill out the form below. It should only take five minutes!

To view the IDFA privacy policy, visit: idfa.org.au/privacy

Update Your Details

Are you an IDFA member?(Required)

Yes

Unsure

What is your membership type?(Required)

Adult

Child (a child under the age of 18 with an immunodeficiency)

Carer (for a person who is a carer of a child or adult with an immunodeficiency)

Stakeholder (a partner or part of an organisation that works with IDFA)

Healthcare Professional

If you're not an IDFA member, would you like to have one of our team members contact you to sign up to join (it's FREE)?(Required)

Yes

Would you like to continue to be an IDFA member?(Required)

Yes

First Name(Required)

Last Name(Required)

Email Address(Required)

Phone(Required)

Title(Required)

Pronouns(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Work Status(Required)

Full-time

Part-time

Casual

Student

Unable to work

Not applicable (child member)

Occupation (if working)

Home Address Line One(Required)

Suburb(Required)

Postcode(Required)

State/Territory(Required)

Do you have a different Postal Address to that listed above?(Required)

Yes

Postal Address Line One(Required)

Suburb(Required)

Postcode(Required)

State/Territory(Required)

Do you have a Primary/ Secondary/ Under investigation Immune Deficiency?(Required)

Primary Immune Deficiency

Secondary Immune Deficiency - E.g. Cancer

Under Investigation

Not Applicable (Carer, Stakeholder, Healthcare Professional)

Please name your confirmed type of primary immunodeficiency eg CVID or SCID(Required)

Only applicable to Adult and Child memberships. Please put N/A for all others

Please name your confirmed type of secondary immunodeficiency – e.g. cancer or viral hepatitis(Required)

Only applicable to Adult and Child memberships. Please put N/A for all others

Patient age at diagnosis(Required)

Only applicable to Adult and Child memberships. Please put N/A for all others

Type of treatment(Required)

IVIg in hospital

SCIg at home

Bone marrow transplant

Antibiotics

Steroids

Gene therapy

Gammainterferon

No treatment

Not Applicable

Other

Would you be open to IDFA contacting you to Share Your Story?(Required)

Yes

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Name

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

Immune Deficiencies Foundation Australia
PO Box 742, Wollongong, NSW 2520
P: 1800 100 198
E: info@idfa.org.au
ABN 99 117 585 976

Immune Deficiency Foundation of Australia (IDFA)

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