Connect With Vega - STAR Therapeutics

Connect With Us

Interested in information about VGA039 and our efforts in bleeding disorders?

All fields marked with an asterisk are required

CRM Enrollment Form (V2)

Form created and launch January 2026 to replace the previous one-page VWD Connect Form.

"*" indicates required fields

X/Twitter

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

Are you a healthcare professional (HCP)?*

Yes

No

Do you live in the United States?*

Yes

No

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Section 1: Audience Identification

What best describes you?*

I am a person living with VWD

I care for someone with VWD

I have a bleeding disorder other than VWD

I care for someone with a bleeding disorder other than VWD

Other

Please describe:*

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Section 2: Details (Based on Audience)

What type of VWD are you diagnosed with?*

Type 1

Type 2

Type 3

I don't know

What type of VWD does the person you care for have?*

Type 1

Type 2

Type 3

I don't know

What bleeding disorder does the person you care for have?*

Which bleeding disorder do you have?*

What is your age?*

0-12 years old

13-17 years old

18-74 years old

75+ years old

What is the age of the person you care for?*

0-12 years old

13-17 years old

18-74 years old

75+ years old

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Section 3: Enrollment and Engagement

Are you interested in learning more about our clinical trials?*

Yes, I'm ready to check eligibility

No, I am just here for general information

Are you interested in learning more about our clinical trials?

I am interested in learning more about the clinical trials

I am interested in becoming a clinical trial site

I am interested in referring patients

I am interested in learning more about the science behind VGA039

Something else: please feel free to reach out to me.

Which of the following professional collaboration opportunities would interest you?

Speaker events

Educational content creation

Surveys, focus groups, or advisory boards

Collaborative research or Investigator Initiated Studies

Something else: please feel free to reach out to me.

Which of the following patient engagement opportunities would interest you?

Sharing my story

Helping create patient education materials

Participating in surveys, focus groups, or advisory boards

Something else: please feel free to reach out to me.

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Section 4: Contact Info

Name*

First Last

Email*

Phone

Street Address

Address Line 1 Address Line 2

Patient City State

City State

HCP City, State*

City * State *

All Zip

ZIP Code

NPI Number

Institution/Practice*

Healthcare Profession*

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South San Francisco, CA 94080
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© 2025 STAR Therapeutics Inc.

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We look forward to connecting with you