Insulin Petitions Downloads

Downloadable copies of the Insulin Choice Petition for those who wish to assist us with signatures from individuals who do not have internet access. Set up to print front and back of US Letter size paper with the full Petition and space for 36 signatures.

Please obtain as many signatures as possible and return to
David Groves, 1102A Thornwood Drive, Birmingham, AL 35209.

Please sign all three online and download copies for your fellow diabetics. Thank you.

Petition: Freedom of choice for insulin users

We the undersigned do hereby Petition the United States Senate and the United States House of Representatives to initiate enabling legislation to immediately restore beef insulin to the United States by domestic or foreign manufacturers.

1. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

2. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

3. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

4. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

5. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

6. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

7. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name15. _________________________________________________
                        Print Name
     _________________________-________-_______________
                 Print City                             State              Zip Code

     _________________________________________________
                        Sign Name

36.   ________________________________________________
                             Print Name
      _________________________-________-_______________
                  Print City                              State              Zip Code

     _________________________________________________
                        Sign Name

Some members may find it easier to retype the Petition and set up the signature name, city, state and zip fields in their own machines, others should find that one of these 3 formats works fine on their machine.

When you have as many signatures as you can get but as soon as possible, please mail as many sheets as you can to:

Thank you. We are hoping to get over 2,000 signatures by 3/31/02, we have about 650 so far thanks to the efforts of 5 people. Even if you can only get 1 or 2 signatures, they will help.