Our organization wishes to be a member of the California Alliance For Health Medical Freedom

Please print out and fax or mail, or copy into an email and send to [email protected]

California Citizens for Health Freedom
8040 Mamie Ave
Oroville, CA 95966
Fax (530) 534-5854

Name of Organization
____________________________________________________________________

Mailing address
___________________________________________________________________
____________________________________________________________________
City                                           State                                                 ZIP/Postal Code

Area code________     Telephone Number ____________________________

Fax area code______ Fax number ____________________________

E-Mail _____________________________________________________

Official goals of organization
____________________________________________________________

Please describe goals and type of organization you are
_____________________________________________________________
_____________________________________________________________

What are your organization's special interest in rights of citizens to have access to non-conventional treatment?
_________________________________________________________________
_________________________________________________________________

Do you have meetings? ________How often? ______________

Who and when did you agree to become members of the Alliance?
___________________________________________________________________

Thank you