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Home
- What is the AAN?
- 2024 AAN Documents
Patients and Carers
Health Professionals
Clinical Trials
AAN Resources
- Amyloidosis Workshop 2023
- Amyloidosis Workshop 2021
  - Patients & Carers webcast recordings
  - Health Professionals webcast recordings
Events
Contact Us

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Apply for Membership – Patient, Family Member or CarerAustralian Amyloidosis Network2022-11-04T10:20:38+11:00

AAN Patient, Family Member or Carer
Membership Application Form

Apply for Full Membership - Patient, Family Member or Carer

Applicant Details

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Last Name *

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State where you reside

How did you become involved with amyloidosis?

I am a:

person with amyloidosis

relative, carer or supporter of someone with amyloidosis

passionate about improving the care of amyloidosis

Other Criteria

I confirm that I do not work in the pharmaceutical industry.

I confirm I am not a health care professional.

Or

I am health care professional, but I prefer to be registered as a patient, carer or family member.

Please provide explanatory remarks: *

Terms & Conditions

I hereby apply to be admitted as a Member of the AAN. If accepted, I consent to act as a Member of the AAN and agree to:

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be bound to the AAN Constitution.

View the AAN Constitution

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abide to the AAN Code of Conduct.

View the AAN Code of Conduct

Regarding payment and financial liability, I agree:

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to pay the annual subscription fee.

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that if AAN Pty Ltd is wound up, to contribute $10 to the property of the Company.

If you are human, leave this field blank.

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Suggested Questions to ask your Doctor

Have you treated many patients with amyloidosis?
What sort of amyloidosis do i have?
What proof is there that I have that type of amyloidosis?
Why do you think the treatment you are suggesting will help me?
What exactly is the treatment and what does it do?
Will this slow my disease or cure it?
Will the treatment make me sick?
How have other patients found this treatment?
How will I you know if the treatment is working and what are the tests that indicate this?
What happens if the treatment does not work or upsets me?
Why is there little treatment for my type of amyloidosis?
Can I work?
How can I help myself?
What information about my disease do you recommend?
Can I meet other patients with my type of amyloidosis?

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FINANCIALLY SUPPORTED BY:

The Neely-Rice Family in memory of Dr Mervyn Neely who died in 1998 from AL cardiac amyloidosis.