Please mail or fax this completed form and any donation to:
American Health Assistance Foundation22512 Gateway Center DriveClarksburg, Maryland 20871Fax: 301-948-4236
A total of up to 10 free brochures may be ordered. However, booklets are limited to 1 free copy of each. For bulk orders, please contact Mr. Jeff Honaker at jhonaker@ahaf.org or by calling 1-800-437-2423.
For orders from outside the U.S., postage and handling fees are applied. Please email name, address and publication selection(s) to jhonaker@ahaf.org for ordering information.
Title
Price
Quantity
Living with Alzheimer's (Booklet)
1 Free Only
Care for the Caregiver: Managing Stress
Free
Alzheimer's Research Review - Free Newsletter
Safety and the Older DriverNote: This same booklet can also be found in the Macular Degeneration and Glaucoma sections on this page.
Staying Safe: Wandering & the Alzheimer's Patient
Understanding Alzheimer's Disease Brochure
Living with Macular Degeneration (Booklet)
Amsler Grid
Low Vision Aid Resource List
Macular Degeneration Research News
Macular Degeneration: The Essential Facts
Safety and the Older DriverNote: This same booklet can also be found in the Alzheimer's Disease and Glaucoma sections on this page.
Living with Glaucoma (Booklet)
National Glaucoma Research Report
Safety and the Older DriverNote: This same booklet can also be found in the Macular Degeneration and Alzheimer's Disease sections on this page.
The Essential Facts on Glaucoma
Total
YES! I would like to make a donation in addition to my publication order.
$10
$50
$25
Other_______
Name
________________________________
Address
City/State/Zip
Country
Check or money order Credit Card
MasterCard
American Express
Visa
Discover
Credit Card:
Expiration Date:
Signature:
Date:
_____/_____/______
Please call 1-800-437-2423 or 301-948-3244 if you have any questions concerning AHAF publications.
Last Reviewed On: 11/21/08
