Support the declaration (citizens)

Copy of Declaration physicians EN

This form is only for physicians who wish to sign the declaration.

If you are a concerned citizen, you may support the declaration here:

I support the Physicians' Alliance against euthanasia and its declaration *

Oui Non

Prefix *

First name *

Middle name

Last name *

Suffix

Email *

Phone

Address *

Address (additional field)

City *

Postal code *

Province *

Country *

Preferred language *

Email list with moderate traffic

Newsletter *

Oui Non

Email list with occasional traffic

Urgent calls to action *

Oui Non

No bulk email

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