Thalidomide health practitioner evidence form
About this resource
Publication date:
        Publication type:
        Fact sheet
  Audience: 
				General public
	Language:
        English
  
                  Part of a collection:              
      
    This form is a template for health practitioners to provide evidence to support an eligible thalidomide survivor (patient) to receive support from the Extraordinary Assistance Fund (EAF) or the Health Care Assistance Fund (HCAF).