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Ostomy Association of Greater
Confidential Membership Application We
invite you to join our Association.
You are especially welcome if you have an ostomy, are preparing for
surgery, are a healthcare professional and/or have a loved one who has had
surgery. We are a completely volunteer
ostomy support group. Our mission
includes the emotional support, education and advocacy of all people with
ostomies. Name
________________________________________________________________________________ Address
______________________________________________________________________________ E-mail ____________________________________Phone (__________) _________________________ Circle the type of
surgery Colostomy Ileostomy Urostomy Continent Procedure Date of surgery ___________ Attend one of our free, open to the public, General
Meetings. There are always friendly
people to talk with you. You may even
want to learn about opportunities to serve the ostomy community on one of our
committees. We always have a need for
talented people to share in our good work.
Membership is free—we operate primarily on donations. Membership includes a subscription to The New Outlook. Please mail this application to Ostomy Association of
Greater Chicago Ms. Judy Svoboda, Membership
Chairperson |
