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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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Name *
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Surname *
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Email *
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What is your movement disorder?
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? *
How did you find out about this event?
Please note that a photographer will be present at this event, please advise your preference
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