Rare Disease Day

Please select as many questions below to answer. We’ll choose one response to use as your #RareAlly quote!*

When it comes to rare disease, who is your rock – your #RareAlly and why? How have they inspired you?
What does #RareAlly mean to you?
What does coming “Together as One” mean to you?
How have you shown up as a #RareAlly to those you work with or in the rare disease community?
How have you seen the firsthand impact of being an ally? For instance, was there a specific moment that sparks memory with a patient, caregiver or advocate? (Please do not include names).

When it comes to rare disease, who is your rock – your #RareAlly and why? How have they inspired you?*

What does #RareAlly mean to you?*

What does coming “Together as One” mean to you?*

How have you shown up as a #RareAlly to those you work with or in the rare disease community?*

How have you seen the firsthand impact of being an ally? For instance, was there a specific moment that sparks memory with a patient, caregiver or advocate? (Please do not include names).*

Consent*

By checking this box, you, the participant and those included in your photographs agree to participation and usage of such photos by Taysha Gene Therapies

I hereby give Taysha Gene Therapies (“Taysha”) consent to use in the following ways my photograph or image submitted using this form (check all that apply):*

Taysha intranet accessible by Taysha employees only
Taysha internet & social media accounts accessible by the public
Taysha employee newsletter
Taysha external newsletter
Taysha annual report
Other

Other*

I further understand that no special compensation will be provided to me for use of my image and that I may not be informed in advance of the specific use of my image.

If any image I submit to Taysha includes others besides myself, I further represent that the individuals in the image have also consented to their inclusion in this submission.

This consent is effective from the date indicated next to my signature below, and will expire six months from this date, unless renewed as indicated by a renewal date added below and initialed by me.

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Date Signed*

Renewal Date*

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Rare Disease Day 2022