FAX TO: St. Louis Chapter (serving eastern Missouri and western Illinois)
FAX #: 314-432-3824
I give permission to my healthcare or service provider to fax my name and contact information to the Alzheimer's Association. I understand that an Alzheimer's Association Helpline representative will contact me about support and educational opportunities. I understand this is a free service provided by the Alzheimer's Association. I understand that my name, contact information or health information listed below will not be disclosed or shared with any other entity unless authorization is obtained by me.