Contact Us

Last Modified: 26 Dec 2013

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.
Non-Research New Patients (except those receiving thank-you services for having made donations AND NOT having a Consultation):
  • Patient Information (required to receive services, including support group membership; and professional membership benefits): PDF, Word, or Online
  • HIPAA Notice of Privacy PracticesPDF or Online
  • Consent for Care and Treatment (required for non-research patients, including in person, tele-medicine, and electronic consultations): PDF or Online
  • Functional EnquiryPDF
  • Medication FlowsheetPDF or Word
Other Forms to Use as Needed:
  • Authorisation for Release of Health Information (if used, one required for each place from where information is being requested): PDF
  • Continuation Sheet: PDF
  • Anatomical Figure: PDF
  • Patient Satisfaction with Clinical Care Survey: PDF or Online
  • Consent to Publicly Publish Personally Identifiable Information: PDF or Online
Health Assessments and Community Physiology Outreach Patients (those requesting thank-you services for having made donations):
  • Health Assessment Request: PDF
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