Name:*
E-mail:
Phone:*
-
Address:*
Message:*
Date of Birth:*
When were you diagnosed with Parkinson's disease?:*
What current medications with daily dosing value of each that you are taking for your Parkinson's symptoms?: *
Are you currently prescribed a daily dose of medications containing 1200mg of L-Dopa or more?: *
Are you currently receiving DBS (deep brain stimulation) treatment?:*
Is the patient wheelchair bound, institutionalized, or immobile?:*
Does the patient have the ability to have video conferences with a computer, tablet, or cell phone with high-speed internet?:*
Verification:

For more information on our approach to Parkinson’s disease send an email to info@parkinsonsclinics.com or call 218-626-2220. After you send your email, we may ask for more information. All communications will be kept confidential. If you have any questions, please call us free of charge.

For more information on our approach to Parkinson’s disease send an email to info@parkinsonsclinics.com or call 218-626-2220. After you send your email, we may ask for more information. All communications will be kept confidential. If you have any questions, please call us free of charge.