Parkinson Workshop Registration Form
Title: "Don't Let Parkinson's Disease Take Over"

Day, Date: Saturday, April 27, 2019
Time: 1 - 2 PM
Venue: MapleCare Physiotherapy Clinic (1173 Wellington Street West, Ottawa, ON K1Y 2Y9)

Speaker: Louise Carrière B.H.Sc.P.T. M.C.P.A., Registered Physiotherapist

First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
How did you hear about the workshop *
Would you be coming by yourself or with a caregiver/someone else? *
Never submit passwords through Google Forms.
This form was created inside of MapleCare Physiotherapy. Report Abuse - Terms of Service