Contact Us

Last Modified: 23 Apr 2017

How to Contact Us

If you are interested in participating in our studies or joining our organisation, either as a professional or support group member, this is the place to begin. We will reply within 24-48 hours. We will not reply to obscene or inappropriate contacts or commercial solicitations. Please do not ask medical questions, but you may ask about making arrangements for a consultation. All online forms below are secure. Thank you for your interest in contacting us!

We are eager to take a proactive role in the biomedical research, healthcare, and peer support group communities and greatly welcome and appreciate input, suggestions, and comments about what we're right and where we can improve.

Forms

Below are specific forms that you may need or wish to complete. To use PDF forms, you will not need a PDF viewer, unless you are downloading them. If you have any questions, please use the form above to make enquiries. Thank you!


NOTE: While FSRG does conduct research, research is not the only activity in which FSRG engages. None of the forms on this page are specifically related to research and signing any of them does not qualify as consenting to research. An additional, specific consent process and forms are required for participation in each individual research project.

New Patients (Non-Research or Research):
  • Patient Information (required to receive services, including support group membership): Online
  • HIPAA Notice of Privacy PracticesPDF or Online
  • Notice of Services and BenefitsOnline
  • Consent for Care and Treatment (required for non-research patients, including in person, tele-medicine, and electronic consultations): Online
  • Review of SystemsOnline
  • Medication FlowsheetPDF
Other Forms to Use as Needed:
  • Continuation SheetPDF
  • Anatomical FigurePDF
  • Patient Satisfaction with Clinical Care SurveyPDF or Online
  • Consent to Publicly Publish Personally Identifiable InformationPDF or Online


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