Hajira Hamza Foundation - Register as Patient/Parent

Our Support

How We Help Patients

As a registered patient or parent, you'll have access to our comprehensive support network designed to help you manage thalassemia.

Free blood transfusion support

Financial assistance for medications

Priority notification for blood availability

Connection to specialist doctors

Community support groups

Educational resources for families

Please fill out the form below accurately. Our team will contact you shortly.

Patient's Full Name *

Date of Birth *

Gender *

Blood Group *

Type of Thalassemia *

Transfusion Frequency

Guardian's Full Name *

Relationship to Patient *

CNIC Number

Phone Number *

Alternative Phone

Email Address

City *

Full Address *

Treating Hospital/Center

Doctor's Name

Current Medications

Additional Medical Notes

What kind of support do you need? (Select all that apply)

Blood Transfusion Support Financial Assistance Medicine Support Transport Assistance Counseling/Support Group

I confirm that the information provided is accurate and consent to be contacted by the foundation *