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Parkinson and Movement Disorder - Free Information Session
Monday 13 May 2019, 1:30pm - 4:30pm
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Title
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Your answer
Name
*
Your answer
Surname
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Email
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Your answer
What is your movement disorder?
Parkinsons
Dystonia
Essential Tremor
Tourette's Syndrome
Carer
Other:
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If you have a movement disorder, who is your GP and what is their address?
This information will be used to invite GPs to a GP Information Session
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Please list any dietary requirements:
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Would you like to be informed of research and events?
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How did you find out about this event?
Support Group
Local GP
Email from Organiser
Other:
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Please note that a photographer will be present at this event, please advise your preference
Yes photos are fine
No photos of me thanks
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