Donation Form
Studies and Research Form
All Financial Gifts Are Gratefully Appreciated to Further Knowledge of Fibromyalgia
and to Help People with Fibromyalgia, their Relatives and Caregivers in New Zealand.
Please Find Enclosed My Gift Towards "Positive Living" Continuing
Please Find Enclosed My Gift Towards Research For Fibromyalgia
All Those Contributing Towards Knowledge Through Research are Warmly Commended
for their Generous Contribution to the Future of Fibromyalgia and the People who Suffer.
I Would Like to Participate in the Following Studies
& Research Yes / NoRed Blood Cell Research For Fibromyalgia Yes / No
This Research will be conducted by Dr Les Simpson of the "Red Blood Cell Research Trust"
For this study to proceed, we need to know of prospective volunteers beforehand.
The charge for the test is $38.00 and there are no ongoing charges. Please register your possible interest.
A Study For People Using Guaifenesin Yes / No
N
ameStreet Address
Suburb and City or Town
P
hone NumberE
mail AddressYour Donation is gratefully appreciated. Thank you. Receipts will be issued.
Print & Post to:
The Editor, ‘Positive Living,’ P. O. Box 28-552, Remuera, Auckland 5