Action on Pre-eclampsia

Blood Pressure Monitor Enquiry Form

Title Mr
Mrs
Ms
Miss
Dr
Rev
Prof
First name
Last name
Contact email address
Organisation name
Telephone number
I would like to request a 50% subsidy in cost for the Cradle VSA Blood pressure monitor for the following reason: I believe I am using the device in a low income setting
I believe I am using the device as part of a medical research project
I belong to a charitable organisation
Other (please specify below)
If other, please specify

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