Understanding Heart Disease

To receive a complimentary CD, “Understanding Heart Disease”, please complete the following form. Allow 4-6 weeks for delivery. Limited to one CD per household.

Shipping Address

*First Name:
*Last Name::
How did you hear about this offer?                         Newspaper                         MD Office                         Web                         Friend/ Family                         Other                       
Who is your Primary Care Physician?
*Required Field

System requirements to run your free CD:
Tray-style CD-ROM
IBM-PC compatible only
Pentium 166 Mhz
Windows 95 +
32 MB Ram
Sound Card

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