Support Us « MDS UK Patient Support Group

Support Us

If you would like more information, membership details or wish to make a contribution please provide the following information on the form below and click “send” Or, click here for a “Printer Friendly Form” to send by post.

If you wish to make a donation online using a credit or debit card, please click here for access to a secure payment server.

Fields which are bold are required

Personal Information

Title

Full Name

Further Details

Additional Information

Are you a patient/carer/other (please specify)?

Reason for contacting us

Contact Information

Address

Post Code

Email Address

Telephone

Donations

Although we are a voluntary charity we do need funds to enable us to expand and improve our services. If you are willing to assist with donations, please make payments to: MDS UK Patient Support Group. All donations will be acknowledged in writing.

I wish to make a donation of

If you are a UK tax payer, the value of your donation can increase by nearly a third under the Gift Aid Scheme.

Please tick this box to join the Gift Aid Scheme