Postcards to Doctors: Request Form
Fill out this form in order to receive both postcards and addresses for clinicians from your area. Keep in mind that Unrest CME is currently certified in the United States only. Please only request as many postcards as you need.
How many postcards would you like to receive?
How many doctors' addresses would you like to receive at this time?
I'll find addresses for clinicians in my area; I don't need to receive any addresses.
Are you planning on having a postcard party or enlisting others to help?
Not sure yet
Please enter your first name
Please enter your last name
Enter your street address
Apt. or Unit # (optional)
Please select the area where you live.
New York, upstate
New York, Long Island and the Five Boroughs
Please enter your zip code.
I promise to replicate the required wording on each postcard. I understand I can add my own, personal message after I have replicated the required wording.
Yes, I promise to do so.
No, I can't promise that.
OPTIONAL: We will be sending periodic updates on the Postcards to Doctors campaign. If you'd like to hear about these updates, please add your email address below. We promise not to spam you with information and we will not add your name to our general mailing list.
A copy of your responses will be emailed to the address you provided.
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