NEW YORK NORTH
Professional Information Request
Name:
Title/Position:
Organization:
Address:
City:
State:
Zip Code:
Daytime Phone:
E-Mail Address:
Please send more information.
Please have an Al-Anon member contact me to discuss how Al-Anon cooperates with the professional community.
I presently refer clients/patients/students to Al-Anon, Alateen:
Yes - Approximate number per year
No, because:
Al-Anon can do the following to assist me as a professional by: