You are not alone.

Add your voice to ours. Complete the form below to register with the Parkinson Society Maritime Region and take advantage of all we have to offer. Our services are free of charge.

If you wish to be included on our e-mail list, leave your information below and we will keep you updated with the latest information on Parkinson's disease, research updates, as well as Society happenings in the Maritimes via our newsletter, Parkinson Express.

If a field does not apply, enter "NA". Please note that we will not share your information with third parties.

First Name*
Last Name*
User Type*	- - select type - - health care professionalfamily member/caregiverstudentliving with Parkinson'sother
Mailing Address
Line 1*
Line 2*
City*
Province*
Postal Code*
Phone Numbers
Primary Phone No*
Secondary Phone No*
Email*
Add to mailing list?*	Yes    No