Parkinson's Foundation: Believe in Better

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Resource Listings Questionnaire (Heartland)

 

Groups who wish to be added to the Parkinson's Foundation local resource listings are required to complete the following online screening questionnaire:

Requests will be reviewed by staff once submitted. Please allow up to two weeks to receive a response.

*1.
Question - Required - Are you currently already posted on our resource list?

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(Maximum response 255 chars, approx. 5 rows of text)

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(Maximum response 255 chars, approx. 5 rows of text)

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Location of meeting or class (note that the Foundation will not be listing specific addresses)

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(Maximum response 255 chars, approx. 5 rows of text)

 

If this is an exercise program,

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  Accepting terms and conditions (circle must be selected to submit this form):
*19.
Question - Required - Individuals acknowledge that inclusion on the Parkinson's Foundation resource listing is with the expectation that the program offered is provided with the highest standards for quality and safety. Additionally, the host organization/individual agrees to use transparent, supportive and open communication when speaking with others about the Parkinson's Foundation.

 
   Please leave this field empty