Joint Statement on Assisted Dying

Thank you for your interest in supporting the Joint Statement Against Assisted Suicide in Eating Disorders. Please complete the form below to add yourself as a signatory.

Name:*

First NameLast Name

What byline would you like included with your name?*

e.g. Physician, Eating Disorder Consultant, Advocate, Executive Director, etc

What credentials would you like included with your name?*

What affiliation would you like included with your name?

If you are representing an organization, please attach your logo.

Choose File

Email:*

example@example.com. Your email will be used solely for Joint Statement updates and will not appear on the paper.

Please select the option that applies to you:*

Eating Disorder ProfessionalCommunity Supporter / Advocate