Please fill in this form :

After completing, you may request a copy of "The GOOD LEAVES magazine" through our Email - (but don't forget to mention your name and postal address..).

ASSOCIATION FOR USERS OF PHYTOTHERAPY

"PHYTO 2000"

WHICH PHYTOTHERAPY FOR PATIENTS ?

WHAT IS THE FUTURE OF PHYTOTHERAPY ?

It will take only a few minutes to fill in this form

NAME :    First name :
Address :
Zip/Town :   Country :
Phone :    Fax :
Occupation :

What do you expect from a Phytotherapy's users association such as Phyto 2000? (please number the following proposals from 1 to 6)

The preservation of this kind of medicine
A permanent information about Phytotherapy
A specific teaching
The setting up of contacts amongst members
The integration of Phytotherapy in the welfare systems
The promotion of a more scientific Phytotherapy

Would you like to be more involved within Phyto 2000 ?

X-mark..

- Setting up links and structures for the development of Phytotherapy in your country ?

yes    no - Joining health comittees
yes    no - Helping to define a new health system
yes    no - Helping to define the phytoterapeutic prescriptions
yes    no - Listing doctors and pharmacists related to Phytotherapy..
yes    no

Other proposals according to your knowledge and opportunities
Please fill in :

Are you able to report about the situation of Phytotherapy in your region/country ?

yes no

Would you like to participate in the making of a book : "Phytotherapy as seen by the Patients, its possibilities and limits" ?

X-mark..

yes no if "Yes", then how :
Being interviewed as a patient ? yes no Transcripting tapes of interviews ? yes no

Would you say that health magazines deliver a complete information about Phytotherapy

yes no Which of these magazines do you read ?

Do you wish to participate in medical meetings ?

X-mark.. yes no

How often ? yes every 3 months yes twice a year yes once a year no

Yes, in Paris

Which Town ? / Country ?

Would you help with the organization of such meetings ?

yes no

Which are your main topics ?

The GOOD LEAVES, the newsletter of PHYTO 2000 is now open to ADVERTISING as long as Products are directly linked to this form of medicine.
Mailed to all its suscribers and available on all medical sites, as well as specialized Pharm-stores, this quarterly magazine has a 5.000 ex. coverage. Thus you will IMPROVE YOUR IMAGE and help our Scientific research. For all information, please Email PHYTO 2000.