Memberships

Haemophilia Foundation of Queensland Inc. (HFQ) is a voluntary organisation of people living with bleeding disorders in Queensland and their families, friends and anyone who is interested in genetic bleeding disorders. HFQ is a member of the Haemophilia Foundation of Australia (HFA). HFA is a member of the World Federation of Haemophilia.

We encourage all people affected by bleeding disorders to become paid members so that:

Your health needs can be better represented in important service provider discussions
We can better support all member that rely on effective clinical and psychosocial support from service providers and state government
We can provide you with communications to help you learn more about new events and supports for people living with bleeding disorders in Queensland
Your family will be well placed to benefit from the improved treatment options and services available to people with bleeding disorders

Your membership supports the overall work of HFQ and by becoming a registered member, you're helping us advocate for improvements and change as well as providing support programs for the health needs and wellbeing of our members.

Key support activities provided by HFQ include;

Education and Health promotion activities (Forums, Facebook and Instagram pages, quarterly magazine “The ‘H’ Factor”)
Community Events (forums, community camp, youth camp, social gatherings and men’s and partners weekends)
OBE’s – Monthly lunch meetings for men living and surviving with a bleeding disorder
Lunch meetings for women who carry a bleeding disorder gene, mums & partners to get together, learn and discuss issues with each other
Regional Events (Cairns, Townsville, Mackay, Rockhampton, Sunshine Coast, Gold Coast & Toowoomba) to support those members of our community living out of Brisbane
Advocacy and Representation for people with bleeding disorders needing help
Welfare support (including no interest loans and urgent financial assistance for HFQ members)

Paid membership allows HFQ to provide vital support programs that are not funded through our state government grant or other donations. Your annual membership will ensure you can participate in the activities of the organisation such as voting at our AGM or receive subsidises or access welfare assistance. The fees are kept deliberately low and they can also be waived if cost is an issue. We also offer a one-off payment to allow you to become registered as a member for life.

Membership fees are $20 per year (inc. GST), or $200 as a one-off lifetime fee. These can be paid online, by direct deposit or cash or cheque through the HFQ office.

If you would like to become a member please complete the membership form below, or click here to download a form that you can complete and email back to: [email protected]; or post to: PO Box 122 Fortitude Valley, QLD 4006.

MEMBERSHIP APPLICATION FOR HAEMOPHILIA FOUNDATION QUEENSLAND

PO Box 122 Fortitude Valley QLD 4006
Mobile: 04 1970 6056
Email: [email protected]

ABN 62 303 495 207. GST Registered. Registered as a Charity in QLD. Association Registeration No: IA02598

Please Note: Membership of HFQ runs from 1 July each year. If this application and payment is made after 1 March it will be deemed to include the next financial year as well.

I wish to be a member of HFQ. My first name is:
My Family name is:
My street number or property name is:	If using a Post Box or Rural delivery, please put the number here
My street name is:	Please include street type (Road, Place etc)
My Suburb is:
My State is:	If joining from overseas, please include country name here.
Post Code:
Email Address:
Mobile phone number:
Home phone number:
Work phone number:
My preferred contact method is:
Date of birth:
I am:
I would like to pay:
I would like to join as:	An individual member A family membership Family membership includes immediate family members (we will send you a request for more information on your family members).
Reason for joining HFQ:
Please indicate your diagnoses details:	Von Willerbrands Disease: (a deficiency of Von Willerbrands factor) Haemophilia A or classic haemophilia: (also called FVIII or factor VIII deficiency) Haemophilia B originally called "Christmas Disease" (also called FVIIX or factor IX deficiency) Haemophilia C: (Also called FXI or factor XI deficiency) Other Bleeding Disorder (please list in the comments box at the end of this form) Acquired haemophilia
If you have haemophilia, please indicate factor level (if known):	Carrier of the haemophilia gene Severe 0% - 1% factor level. Moderate 1% - 5% factor level. Mild 5% - 50% factor level. If you don't know your level or it is greater than 50% please choose carrier.
My details can be shared with Haemophilia Foundation Australia (HFA):	HFQ membership automatically entitles you to have access to HFA services and programs, including receiving their quarterly newsletter National Haemophilia. Mark this box if you want your name and address recorded on the HFA database
I have read and accept the HFQ privacy Policy:	HFQ respects and upholds your rights to privacy protection. Apart from HFA (if indicated) your details will NOT be provided to other organisations or individuals without your permission and no release of information will be made without your informed consent unless requested by law. In accordance with the National Privacy Principles, we have a detailed Privacy Policy and a set of procedures regulating how we collect, use, disclose, and hold your personal information.
Do you have anything else you'd like to tell us?:	Please use this space to tell us anything else you'd like us to know.
Declaration:	I accept the objects and rules of Haemophilia Foundation Queensland Inc. and apply for membership of the Foundation. I agree to my personal information being held by the Foundation and used in accordance with the Foundation’s Privacy Policy.