LCSS Order Form and License Fee
the LCSS Introductory Packet:
1. Please complete the order
the formats below). You can edit (type in your information) in the
microsoft word version and print it from your browser. The PDF
format must be printed and filled out manually.
Please see the list on the order form for what it included in the packet.
2. Mail priority mail with a CHECK or MONEY ORDER
made payable to
of Life Research Associates, LLC"
do not mail cash).
Mail order form and payment to:
Patricia Hollen, PhD, RN, FAAN
Quality of Life Research Associates, LLC
548 Worthington Drive
Charlottesville, VA 22903
Order form file formats - please read carefully.
Form - Microsoft Word Doc
This link will open the order form
document in a separate browser window. After printing, close
the browser window to return to this page. If you have an
older browser, please save the document (41KB) to your hard
drive as the dialog box suggests. To download: open order
form from the link above. Go to FILE>SAVE AS in your
browser and save as word document.