Understanding Prostate Cancer Order Form

Understanding Prostate Cancer is a comprehensive and compassionate guide written by Dr. Michael McCormack and Dr. Fred Saad of the Centre hospitalier universitaire de Montréal (CHUM). The book introduces and explains the many issues surrounding risk factors and prevention of prostate cancer and provides answers to questions for those who have a diagnosis of prostate cancer, their families and loved ones.

Yes, I would like a free copy of the book Understanding Prostate Cancer.

My mailing address and contact information is:
PROCURE does not share contact information with any other individual or organization.

All fields marked whit a (*) must be filled out.

Dr. Mr. Mrs. Ms.
First Name:
Family Name:
*Email:
*Address:		Apartment:
*City:
Province:	-- Alberta British Columbia Newfoundland/Labrador New Brunswick Northwest Territories Nova Scotia Nunavut Manitoba Ontario Prince Edward Island Quebec Saskatchewan Yukon	*Postal Code:
Telephone:	-
Please send the book in: English French
I learnt about the free book offer via: -- Magazine Newspaper Website Radio TV Other
Name of the source (magazine, TV program):
Please note that the free book offer is available in Canada only while supplies last. Thank you!

---

(Optional) Please put me on the PROCURE Mailing List.
Link to Prostate Cancer
Myself, since
Family Member
Friend or Other
No Link
	I prefer to be contacted through email.
	Use mailing address above.
	Use new mailing address as follows:

Name:
Address:		Apartment:
City:
Province:	-- Alberta British Columbia Newfoundland/Labrador New Brunswick Northwest Territories Nova Scotia Nunavut Manitoba Ontario Prince Edward Island Quebec Saskatchewan Yukon	Postal Code:
Telephone:	-

PROCURE wishes to thank the authors for allowing its distribution by us and sanofi-aventis for generously making it available free of charge. The contents of this publication are the sole responsibility of the authors.