Medical Professional Request for PIB(s) to go to their patient

Patient Information Booklets

Patient Information Booklets

Fight Bladder Cancer has produced a suite of Patient Information Booklets that are available to order for your patients. These are supplied free of charge.

**Please note: When you order the booklets for your patients, these will be of a smaller and more manageable size, slightly bigger than A5**

Please complete this form and they 
will be sent free of charge directly to your patients from the Fight Bladder Cancer office.
Referring Healthcare Professional's details:

Please provide us with a contact number, in case we have any queries regarding your request:

Patient's details:

Thank you for completing this form, we will arrange for these materials to be sent to your patient as soon as possible. Please contact the Fight Bladder Cancer office on 01844 351621 if they haven't arrived within 7 working days.

Your data

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