Information Requests Mail in Form

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Please Print This Form Out!

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How to obtain the medical disease information from the American Autoimmune Related Diseases Association, Inc.

 

Print this out and mail it to the address below

Detailed information is available for many of the autoimmune diseases and may be obtained for free. We apologize that due to the extremely heavy demand, we are unable to fufill requests for free information online. If you cannot afford a donation (to cover mailing costs) simply print and complete this form and mail to AARDA at the address below.

If you are able to make a contribution to help defray the cost of postage and handling, any amount you care to give would be appreciated.

 

Please print the name of the disease here: _________________________________________________________________________________

Please check one: [   ] I cannot afford a donation at this time. [   ] Donation in the amount of $____________ enclosed.

Name ______________________________________________

Postal Address _______________________________

City ______________________ State ____ ZIP ______

Country __________

Telephone _________________________

E-mail address ___________________________

Comments or questions for AARDA? __________________________________________________________________________________

___________________________________________________________________________________________________________________

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American Autoimmune Related Diseases Association, Inc.

22100 Gratiot Avenue

Eastpointe, MI 48021


aarda@aarda.org