AMEN-Israel Myeloma Association
CONTACT SHEET
Shalom
A group of founders are now establishing an association (AMEN) which is meant to benefit
the welfare of myeloma patients in Israel, improve quality of life, centralize information on
the disease, treatments, meds and research etc as well as suggestions for treatment vis a vis
support agencies like Bituah Leumi [Social Security], insurance companies, various rights etc,
as well as other subjects which will help the patient and family members get through a
difficult period of adaptation and the establishment of a viable quality of life in light of the
new situation they face.
In short order our Hebrew language website which will have medical info and more will be up
and will be a home to the myeloma family, a place from which to learn, to which to write,
through which to ask, recommend and get updates.
In order to reach each patient of the myeloma family with support and information, we ask
you to contact us by sending us the attached form after completing all the details. All details
sent will be maintained for our contact purposes and will not be passed on to any other cause
without authorization.
Much health---from the staff of the Association
Address for mail: POB 2020 Savyon Zip 56514
email :yigaltim@netvision.net.il
Contact people: Mati Raviv 052 258 7612 Zipy Farber 052 396 1210
[from overseas drop the 0 in the prefix and add 972]
mati-r@013.net.il
zipyfarb@netvision.net.il
fax 03 504 7971
fax 03 649 8656
Details
Last name______________ First name ______________ M/F ID#______________
Address______________________________________________________________
Date of birth______________
Medical Center_____________________________
Tel #___________ Mobile____________ Fax_____________________
Note if you wish to help the association and if so in what area (mark with X)
[] Active on the board of the association
[] Active as requested by the association
[] Help raise money for association activities
[] PR to get signed pledges
[] Personal financial donation
[] Writing or editing the association bulletin or participation in translation and distribution of
professional flyers [brochures/material] (with participation of doctors)
Other (please detail)____________________________________________
Note: _______________________________________________
Signature: ____________________________________________

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