Endorse the People's Charter for Health - People's Health Movement PHM

If you, or your organisation want to endorse the People's Charter for Health and join this global movement for health, social justice and equity, please take a moment or two to complete this simple form.

We'll keep in touch with and let you know how other people and organisations around the world are working to implement the Charter, and how you and your organisation can become involved in that effort.

Please complete and submit this questionnaire electronically, or mail it to the address given at the end.

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1. Please provide main address details:

Date:
Contact Name:
Job Title/Dept.:
Organisation:
Address 1:
Address 2:
Town / City:
State / County:
Zip / Postal Code:
Country:

2. Please provide other contact details:

Telephone:
Fax:
E-mail:
Website:

3. Yes. I want to endorse the People's Charter for Health:

Personally

On behalf of my organisation

Please tick if you want to be kept up to date with information about the PHA Movement.

Thank you for endorse the People's Charter for Health and joining the People's Health Movement.

Please click on the submit button to submit the form to us, or print it off and post it to:

PHM Secretariat

Endorse the People's Charter for Health!