Family Caregiver Sign Up

Become part of NFCA's Family Caregiver Community!

Sign up TODAY to access the latest resources, connect with others, and find support with NFCA's Family Caregiver Community…

Throughout the year, we offer members who sign up FREE resources including:

• NFCA's quarterly e-newsletter, TAKE CARE! with information and resources about the experiences of caregiving. To receive a print version of the newsletter in the mail, please join at the special, $10 introductory rate.
• An educational library with resources to support your day-to-day responsibilities
• An online story bank with stories from caregivers across the country
• A Pen Pal program that connects you directly with others who are caring for loved ones
• Monthly E-letters created exclusively for family caregivers

NFCA Family Caregiver Community

Yes! I want to sign up for FREE because I am a family caregiver

Personal Information
Name* (first and last):
Address 1*:
Address 2 (Apt. #, etc.):
City*:
State*:
ZIP Code*:
Telephone Number*:
E-Mail Address*:
How did you hear about the NFCA?	Select One... Family Caregiver Gift Bag The Today Show Family/Friend Community Association Caregiver Conference Care Facility Doctor/Nurse Social Worker Internet Newspaper Magazine Radio TV Stamp Letter
1. How many years have you been caring for your loved one?   0-5 years   6-10 years   11+ years 2. What is your relation to the person for whom you're caring? I am the:   Spouse   Parent   Sibling   Child    Other 3.What is your age?   Under 11   11-20   21-35   36-50   51-65   65+ 4. What is the age of your loved one?   Under 11   11-20   21-35   36-50   51-65   65+ 5. Where does your loved one live?   With me   Nursing home/assisted living facility   On their own   Other family member    Other 6. What is the primary illness or disability of your loved one? CHECK ONE ONLY   ALS   Alzheimer's/Dementia   Birth Defects/Related Conditions   Cancer   Cerebral Palsy   Diabetes   Frail/Elderly   Heart Disease   Age-Related Macular Degeneration   Mental Illness   Mental Retardation/Developmental Disorder   Multiple Sclerosis   Parkinson's Disease   Pulmonary Disease   Renal Disease   Spinal Cord Injury   Stroke   Traumatic Brain Injury    Other Please enter the above letters and numbers in the box below:
Note: NFCA will keep all of your information confidential; it will not be shared with any third parties. View our privacy policy here.
National Family Caregivers Association 10400 Connecticut Avenue, Suite 500 Kensington, MD 20895-3944