RALiving - Sign up for more information


Get to know your RA in a new way

Living with rheumatoid arthritis

RA in body

RA in mind

Building your team

RAliving resources


Sign up for your free information kit now and you'll also receive an RA Quality of Life Monitor.



The better you understand your RA, the better you can manage the impact it has on your quality of life. And that can mean hope. Hope that you can move beyond doing the things you have to do and start doing the things you want to do.

Whether you've just been diagnosed with RA, or you're thinking about changing your treatment, it could be time for you to learn more about how RA is affecting you from day to day. Find out by requesting your RALiving information kit today and you'll also receive information about a different treatment option.

Your RALiving information kit includes:

the education brochure explaining 8 Ways RA can affect you
the 4-week Quality of Life Monitor to track and share with your physician
a note pad to jot down or highlight important ideas

Please fill out the following information.*Indicates required field

About You


*I would like to request information about:
*I am a:	Patient Caregiver

Salutation:

*Name:

*Address 1:

Address 2:

*City/State/ZIP:

*Phone:

*E-mail Address:

*Confirm E-mail Address:

*Date of Birth:

Gender:	Male Female

Ethnicity:

Your Information Preferences

How would you prefer to receive information when available?

By mail only

By e-mail only

By mail and e-mail

Would you prefer to receive information in Spanish, when available?

Yes

About Your Treatment

About The Patient

*Have you been diagnosed with rheumatoid arthritis? *Has the person in your care been diagnosed with rheumatoid arthritis (RA)?

Yes

Don't Know

What type of physician are you seeing? What type of physician is the patient seeing?

How long ago were you diagnosed? How long ago was the patient diagnosed?

<1 Year	1-2	2-3	3-5	5-10	10+ Years

*How is your current medication(s) administered? *How is his/her current medication(s) administered?

Infusion (IV)

Injection (shot)

Oral (pill)

Not currently taking a medication

Are you currently taking a steroid medication such as prednisone? Is the patient currently taking a steroid medication such as prednisone? Is the child in your care currently taking a steroid medication such as prednisone?

Yes

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Bristol-Myers Squibb.