Information resources Order form July 2017 How to order All of our most up-to-date information is available at parkinsons.org.uk/information-and-support If you would prefer to read printed copies of our information, you can place an order using this form. All of our resources are free of charge, with free delivery. If you are ordering from overseas, we will contact you about postage costs. Just complete this order form in BLOCK CAPITALS and send it to: Parkinson s UK PO Box 485 Grays RM17 9HY You can also place an order by calling 0845 121 2354 or emailing resources@parkinsons.org.uk Donations Our resources are free of charge, but if you wish to make a donation, please complete the details on the back page of this form. We accept donations by Maestro, Mastercard, Visa, cheque and postal order. Please do not send cash in the post. Large print versions If you need our information in large print, please let us know when you place your order. To keep our costs down, we don t hold stocks of these, but we can produce them for you individually. Other languages If you need one of our resources in another language that isn t listed on this form, call the helpline on 0808 800 0303 for advice. Title First name Surname Delivery address City Postcode County Country Telephone* Email* *Providing your phone number or email address will help us to contact you quickly if we have a question about your order. Finally, we d like to find out a little more about you. The following questions are optional, but your answers will help us improve our services and ensure our information is reaching a broad range of people. Please choose the option that best fits you. I have Parkinson s I care for someone with Parkinson s I have a friend or family member with Parkinson s I m a professional working with people with Parkinson s Other (please specify) What is your ethnic background? Asian or Asian British Black or Black British Chinese Mixed White British White other Other (please specify) 1
Resources in other languages and accessible formats are listed on page 6 of this form. About Parkinson s A quick introduction to Parkinson s L001 Diagnosing Parkinson s FS48 Easy read information about Parkinson s B501 New to Parkinson s? DVD V012 Parkinsonism FS14 Parkinson s alert card M014 Parkinson s alert card for those with hearing difficulties M014D Parkinson s and you (including B023 resources guide) B181 Taking control of your life with Parkinson s B503 Symptoms and lifestyle Anxiety and Parkinson s FS96 Communication and Parkinson s FS06 Daily living equipment for people with Parkinson s WB22 Dementia with Lewy bodies FS33 Dental and oral health in Parkinson s FS98 Depression and Parkinson s FS56 Diet and Parkinson s B065 Driving and Parkinson s B064 Eating, swallowing and saliva control in Parkinson s FS22 Eyes and Parkinson s FS27 Falls and Parkinson s FS39 Fatigue and Parkinson s FS72 Foot care and Parkinson s FS51 Freezing in Parkinson s FS63 Hallucinations and delusions in Parkinson s FS11 Impulsive and compulsive behaviour in Parkinson s FS77 International travel and Parkinson s FS28 Intimate relationships and Parkinson s B034 Living alone with Parkinson s FS29 Living with Parkinson s B077 Looking after your bladder and bowels when you have Parkinson s B060 Low blood pressure and Parkinson s FS50 Mild memory and thinking problems in Parkinson s FS95 Monitoring your Parkinson s FS69 Muscle cramps and dystonia FS43 Pain in Parkinson s FS37 Parkinson s dementia FS58 Preparing for end of life B092 Restless legs syndrome and Parkinson s FS83 Skin and sweating problems in Parkinson s FS40 2
Resources in other languages and accessible formats are listed on page 6 of this form. Symptoms and lifestyle (continued) Sleep and night-time problems in Parkinson s B070 Talking to children about Parkinson s FS66 Talking to people about Parkinson s FS88 Thinking about advanced Parkinson s B003 Tips and hints for people with Parkinson s B011 Tremor and Parkinson s FS94 Using computers and the internet FS60 Wearing off and involuntary movements (dyskinesia) FS73 Treatments and therapies Apomorphine FS26 Complementary therapies and Parkinson s B102 Drug treatments for Parkinson s B013 Non-motor symptoms questionnaire B117 Occupational therapy and Parkinson s FS97 Parkinson s medication card M001 Parkinson s medication record B145 Physiotherapy and Parkinson s FS42 Speech and language therapy and Parkinson s FS07 Surgery and Parkinson s B123 Talking to your GP, specialist or Parkinson s nurse about Parkinson s FS71 Family and carers Keeping a diary: for carers FS70 My Dad has Parkinson s B089 My Mum has Parkinson s B088 My Gran has Parkinson s B086 My Grandad has Parkinson s B087 The carer s guide B071 Money, work and practical matters Attendance Allowance WB02 Carer s Allowance WB08 Disability Living Allowance WB03 Employment and Parkinson s B103 Employment and Support Allowance WB16 General information about benefits WB01 Grants and loans WB15 Help with Council Tax WB12 Help with getting around WB10 Help with health costs WB09 Housing Benefit WB13 Income Support WB07 Jobseeker s Allowance WB19 Pension Credit WB05 Personal Independence Payment WB20 Universal Credit WB21 Working Tax Credit WB04 3
Resources in other languages and accessible formats are listed on page 6 of this form. Going into hospital Get It On Time clock poster (A4) B105B Get It On Time clock poster (A5) B105A Get It On Time flyer (A5) B105 Get It On Time poster (A4) P055 Get It On Time stickers (A4-35 per sheet) B106 Get It On Time stickers (A5-15 per sheet) B106A Get It On Time washbag B150 Maximum of 10 Going into hospital when you have Parkinson s B182 Resources for professionals Caring for your patient with Parkinson s B030 Caring for your resident with Parkinson s B114 Get It On Time information leaflet for professionals B104 Get It On Time Medicine optimisation for patients with Parkinson s DVD Get It On Time Medicine optimisation for residents with Parkinson s DVD Key information for community pharmacists Key information for hospital pharmacists Parkinson s: a guide for home care workers Parkinson s research An introduction to taking part in research Inherited Parkinson s and genetic testing Progress magazine (latest copy) Real hope for a cure poster (A3) Real hope for a cure poster (A4) This is the most exciting time in Parkinson s research poster (A3) This is the most exciting time in Parkinson s research poster (A4) About Parkinson s UK Customer feedback postcard Information resources catalogue Information resources order form Membership enquiry booklet and application form Parkinson s information and support Recently diagnosed with Parkinson s? A guide to our information resources V015 V014 PK0148 L036 B500 PK0421 FS86 B118 PK0150 PK0149 PK0152 PK0151 M016 B027 B029 PK0010 L025 B023 4
Resources in other languages and accessible formats are listed on page 6 of this form. Fundraising In memory flyer PK0411 Jewellery recycling envelope B153 Legacy booklet B168 Legacy leaflet B169 Unity lottery leaflet B143 5
Resources in community languages A quick introduction to Parkinson s leaflet (enter number required in the box) Bengali L001B Gujarati L001G Hindi L001H Polish L001POL Punjabi L001P Scots Gaelic L001SG Urdu L001U Information and support leaflet (enter number required in the box) Bengali L025B Gujarati L025G Hindi L025H Polish L025POL Punjabi L025P Scots Gaelic L025SG Tamil L025T Turkish L025TUR Urdu L025U Welsh L025W New to Parkinson s? DVD (enter number required in the box) Bengali V016B Gujarati V016G Hindi V016H Punjabi V016P Sylheti V016S Tamil V016T Urdu V016U Parkinson s and you booklet (enter number required in the box) Bengali B181B Cantonese B181C Gujarati B181G Hindi B181H Polish B181POL Punjabi B181P Somali B181S Turkish B181T Urdu B181U Welsh B181W Accessible formats The carer s guide (3 audio CD set) B071C Parkinson s and you (2 audio CD set) B181AUD New to Parkinson s? DVD with subtitles V012S 6
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Donations Total Our resources are free of charge, but if you wish to make a donation, please enter the amount in the column on the right. All donations are gratefully received. Please sign the box below if you wish to give via Gift Aid. Boost your donation by 25p of Gift Aid for every 1 you donate I would like Parkinson s UK to treat all donations I have made during the previous four years and all donations I make in the future as Gift Aid donations, until I notify them otherwise. I confirm that I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. Signature Date Please notify us if you wish to cancel this declaration, change your name or home address, or no longer pay sufficient Income Tax and/or Capital Gains tax, by contacting our Supporter Services team on 0800 138 6593. Methods of payment I wish to pay by Maestro/Mastercard/VISA and authorise you to debit my account with the purchases on this form. (Please note there is a 5 minimum payment when paying by credit card) PLEASE TICK BOX Cheque payment I enclose a cheque for made payable to Parkinson s UK Date of order Card number Valid from / Expires end / Billing address (if different from delivery address) Title Initials Surname Address Maestro (only) issue no. Name as it appears on card... Security code Last 3 digits on the signature strip on the back of your card Postcode Complete if cardholder is different from the person whose details are on the front cover Title Initials Surname Address Postcode DATA PROTECTION We will not share your details with any other third party or organisation for marketing purposes other than that of Parkinson s UK, and we will never sell your data. If you d like to update your details or you no longer wish to hear from us, please contact our Supporter Services team on 0800 138 6593. To find out more about how we use your data, visit parkinsons.org.uk/fundraising-privacy This form is up-to-date as of July 2017. Items are subject to availability, and may be withdrawn or replaced. If you d like to check availability before placing your order, call 0845 121 2354 or email resources@parkinsons.org.uk. Parkinson s UK, 215 Vauxhall Bridge Road, London SW1V 1EJ Tel 020 7931 8080 Fax 020 7233 9908 Helpline 0808 800 0303 Email hello@parkinsons.org.uk Website parkinsons.org.uk Parkinson s UK, July 2017. Parkinson s UK is the operating name of the Parkinson s Disease Society of the United Kingdom. A company limited by guarantee. Registered in England and Wales (948776). Registered office: 215 Vauxhall Bridge Road, London SW1V 1EJ. A charity registered in England and Wales (258197) and in Scotland (SC037554). 8 B029