Resign from Program...

Important: Please be sure to notify your patient/senior that you are unable to stay with the Chemo Angels Program at this time. No details are necessary, (remember, do not share anything negative with your patient/senior!) but your patient/senior WILL worry about you if you do not write to say goodbye and let them know that you are leaving the program. The Chemo Angels administration does not notify patients/seniors when an Angel resigns.

Full Name:
Address:
City, State, Zip:
Country:

E-mail address:

Your Patient/Seniors full name:

How long have you been an Angel:

On what date will you stop Angeling

Please select from the following: My patient/senior graduated passed away was removed is still with the program

Please select from the following: I was a Chemo Angel Card Angel Senior Angel

Chemo Angels Yahoo Groups: Please indicate below which Yahoo Groups you belong to. (Example: Main Angels Group, Special Assignment, state group, prayer group, etc.)

Use this box for any comments you might have

Important: Will you be sure to notify your patient/senior and say goodbye? Yes, I will.

Resignation Form