www.parkinson.org
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2620:12a:8001::3
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Submitted URL: https://secure3.convio.net/prkorg/site/R?i=3SVmzAhPcnzc0tGkuMykHbPXE_WyMYAifMPpvhaeIiDz-fRkgmrKHA
Effective URL: https://www.parkinson.org/events/2024/June5WW
Submission: On June 03 via api from US — Scanned from DE
Effective URL: https://www.parkinson.org/events/2024/June5WW
Submission: On June 03 via api from US — Scanned from DE
Form analysis 4 forms found in the DOM
GET /search
<form role="search" method="GET" action="/search" data-once="form-updated cvJqueryValidate" data-drupal-form-fields="" novalidate="novalidate">
<input class="js-mobile-search-field" type="search" name="keywords" aria-label="Search" placeholder="Search">
<button class="js-mobile-search-submit" type="submit" aria-label="Submit" disabled=""></button>
</form>GET /search
<form role="search" method="GET" action="/search" data-once="form-updated cvJqueryValidate" data-drupal-form-fields="" novalidate="novalidate">
<input class="js-global-search-field autocomplete form-autocomplete ui-autocomplete-input" type="search" name="keywords" aria-label="Search" placeholder="Search" data-id="global_search" data-once="autocomplete" autocomplete="off">
<button class="js-global-search-submit" type="submit" aria-label="Submit" disabled=""></button>
</form>POST /events/2024/June5WW
<form
class="webform-submission-form webform-submission-add-form webform-submission-newsletter-sign-up-form webform-submission-newsletter-sign-up-add-form webform-submission-newsletter-sign-up-node-3169-form webform-submission-newsletter-sign-up-node-3169-add-form js-webform-details-toggle webform-details-toggle"
data-drupal-selector="webform-submission-newsletter-sign-up-node-3169-add-form" action="/events/2024/June5WW" method="post" id="webform-submission-newsletter-sign-up-node-3169-add-form" accept-charset="UTF-8"
data-once="form-updated webform-details-toggle webform-cards cvJqueryValidate" data-drupal-form-fields="edit-email-address,edit-email-opt-in,edit-actions-submit" novalidate="novalidate">
<div class="js-form-item form-item js-form-type-email form-type-email js-form-item-email-address form-item-email-address form-no-label">
<label for="edit-email-address" class="visually-hidden js-form-required form-required">Email Address</label>
<input class="email-sign-up-input form-email required" data-drupal-selector="edit-email-address" data-msg-maxlength="Email Address field has a maximum length of 254." data-msg-required="Email Address field is required."
data-msg-email="Email Address does not contain a valid email." type="email" id="edit-email-address" name="email_address" value="" size="60" maxlength="254" placeholder="Email Address" required="required" aria-required="true">
</div>
<div class="hidden js-form-item form-item js-form-type-select form-type-select js-form-item-email-opt-in form-item-email-opt-in">
<label for="edit-email-opt-in">Email Opt In</label>
<select data-drupal-selector="edit-email-opt-in" multiple="multiple" name="email_opt_in[]" id="edit-email-opt-in" class="form-select">
<option value="1021" selected="selected">1021</option>
<option value="1022" selected="selected">1022</option>
<option value="1023" selected="selected">1023</option>
<option value="1461" selected="selected">1461</option>
<option value="1861" selected="selected">1861</option>
</select>
</div>
<div data-drupal-selector="edit-actions" class="form-actions webform-actions js-form-wrapper form-wrapper" id="edit-actions"><input
class="webform-button--submit email-sign-up-submit btn button button--primary js-form-submit form-submit cv-validate-before-ajax" data-drupal-selector="edit-actions-submit" data-disable-refocus="true" type="submit" id="edit-actions-submit"
name="op" value="Sign Up" data-once="webform-clientside-validation-ajax drupal-ajax">
</div>
<input autocomplete="off" data-drupal-selector="form-llmgnkmdfloxnpbod9a1lg1fhi4b7myrl3-wckamri4" type="hidden" name="form_build_id" value="form-LlmgnKmdFLoxnpBod9A1LG1Fhi4B7mYrl3-wCkaMrI4">
<input data-drupal-selector="edit-webform-submission-newsletter-sign-up-node-3169-add-form" type="hidden" name="form_id" value="webform_submission_newsletter_sign_up_node_3169_add_form">
</form>POST /events/2024/June5WW
<form
class="webform-submission-form webform-submission-add-form webform-submission-luminate-sign-up-form webform-submission-luminate-sign-up-add-form webform-submission-luminate-sign-up-node-3169-form webform-submission-luminate-sign-up-node-3169-add-form js-webform-autofocus js-webform-details-toggle webform-details-toggle webform-cards"
data-current-page="" data-progress-link="" data-toggle-show-label="Show all" data-toggle-hide-label="Hide all" data-ajax-effect="none" data-ajax-speed="500" data-drupal-selector="webform-submission-luminate-sign-up-node-3169-add-form"
action="/events/2024/June5WW" method="post" id="webform-submission-luminate-sign-up-node-3169-add-form" accept-charset="UTF-8" data-once="form-updated webform-details-toggle webform-cards cvJqueryValidate"
data-drupal-form-fields="edit-first-name,edit-last-name,edit-send-me-communications-from-my-local-chapter,edit-zip-code-postal-code,edit-what-is-your-parkinsons-connection,edit-are-you-involved-with-the-person-with-parkinsons-care,edit-year-of-parkinsons-diagnosis,edit-address-info-address,edit-address-info-address-2,edit-address-info-city,edit-address-info-state-province,edit-address-info-country,edit-phone-number,edit-are-you-a-veteran,edit-which-language-would-you-prefer-to-hear-from-us-in,edit-how-did-you-hear-about-the-parkinson-s-foundation,edit-cards-prev,edit-cards-next,edit-actions-submit"
data-webform-current-card="basic_info" novalidate="novalidate">
<div class="webform-progress">
<div class="webform-progress__status">
<span class="webform-progress__summary" data-webform-progress-summary="">1 of 4</span>
</div>
</div>
<div class="webform-required">
<span class="form-required"></span>Indicates required field
</div>
<section data-drupal-selector="edit-basic-info" data-title="Basic Info" data-webform-key="basic_info" id="edit-basic-info" class="js-form-wrapper form-wrapper webform-card webform-card--active">
<h2 class="webform-card-title">Basic Info</h2>
<div class="webform-card-wrapper">
<input class="multistep-newsletter-email-address" data-drupal-selector="edit-email-address" type="hidden" name="email_address" value="">
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-first-name form-item-first-name">
<label for="edit-first-name" class="js-form-required form-required">First Name</label>
<input data-drupal-selector="edit-first-name" data-msg-maxlength="First Name field has a maximum length of 255." data-msg-required="First Name field is required." type="text" id="edit-first-name" name="first_name" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true">
</div>
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-last-name form-item-last-name">
<label for="edit-last-name" class="js-form-required form-required">Last Name</label>
<input data-drupal-selector="edit-last-name" data-msg-maxlength="Last Name field has a maximum length of 255." data-msg-required="Last Name field is required." type="text" id="edit-last-name" name="last_name" value="" size="60"
maxlength="255" class="form-text required" required="required" aria-required="true">
</div>
<div class="js-form-item form-item js-form-type-checkbox form-type-checkbox js-form-item-send-me-communications-from-my-local-chapter form-item-send-me-communications-from-my-local-chapter">
<input data-drupal-selector="edit-send-me-communications-from-my-local-chapter" type="checkbox" id="edit-send-me-communications-from-my-local-chapter" name="send_me_communications_from_my_local_chapter" value="1" class="form-checkbox">
<label for="edit-send-me-communications-from-my-local-chapter" class="option">Send me communications from my local chapter</label>
</div>
<fieldset data-drupal-selector="edit-zip-code" id="edit-zip-code--wrapper"
class="webform-address--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-webform-address webform-type-webform-address js-form-item form-item js-form-wrapper form-wrapper">
<legend>
<span class="visually-hidden fieldset-legend">Zip Code</span>
</legend>
<div class="fieldset-wrapper">
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-zip-code-postal-code form-item-zip-code-postal-code">
<label for="edit-zip-code-postal-code" class="js-form-required form-required">ZIP</label>
<input data-drupal-selector="edit-zip-code-postal-code" data-msg-maxlength="ZIP field has a maximum length of 255." data-msg-required="ZIP field is required." type="text" id="edit-zip-code-postal-code" name="zip_code[postal_code]"
value="" size="60" maxlength="255" placeholder="Zip Code" class="form-text required" required="required" aria-required="true">
</div>
</div>
</fieldset>
</div>
</section>
<section data-drupal-selector="edit-parkinsons-connection" data-title="Parkinson's Connection" data-webform-key="parkinsons_connection" id="edit-parkinsons-connection" class="js-form-wrapper form-wrapper webform-card">
<h2 class="webform-card-title">Parkinson's Connection</h2>
<div class="webform-card-wrapper">
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-what-is-your-parkinsons-connection form-item-what-is-your-parkinsons-connection">
<label for="edit-what-is-your-parkinsons-connection">What is your Parkinson's connection?</label>
<select data-drupal-selector="edit-what-is-your-parkinsons-connection" id="edit-what-is-your-parkinsons-connection" name="what_is_your_parkinsons_connection" class="form-select">
<option value="" selected="selected">Please select response</option>
<option value="Person with PD">Person with PD</option>
<option value="Spouse/Partner">Spouse/Partner</option>
<option value="Parent has / had PD">Parent has / had PD</option>
<option value="Other family of person with PD">Other family of person with PD</option>
<option value="Friend of person with PD">Friend of person with PD</option>
<option value="Healthcare Professional">Healthcare Professional</option>
<option value="Other">Other</option>
</select>
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-are-you-involved-with-the-person-with-parkinsons-care form-item-are-you-involved-with-the-person-with-parkinsons-care">
<label for="edit-are-you-involved-with-the-person-with-parkinsons-care">Are you involved with the person with Parkinson's care?</label>
<select data-drupal-selector="edit-are-you-involved-with-the-person-with-parkinsons-care" id="edit-are-you-involved-with-the-person-with-parkinsons-care" name="are_you_involved_with_the_person_with_parkinsons_care" class="form-select">
<option value="" selected="selected">Please select response</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
</select>
</div>
<div class="js-form-item form-item js-form-type-number form-type-number js-form-item-year-of-parkinsons-diagnosis form-item-year-of-parkinsons-diagnosis">
<label for="edit-year-of-parkinsons-diagnosis">Please share the year of Parkinson's diagnosis:</label>
<input autocomplete="off" data-drupal-selector="edit-year-of-parkinsons-diagnosis" type="number" id="edit-year-of-parkinsons-diagnosis" name="year_of_parkinsons_diagnosis" value="" step="any" class="form-number">
</div>
</div>
</section>
<section data-drupal-selector="edit-address" data-title="Address" data-webform-key="address" id="edit-address" class="js-form-wrapper form-wrapper webform-card">
<h2 class="webform-card-title">Address</h2>
<div class="webform-card-wrapper">
<fieldset data-drupal-selector="edit-address-info" id="edit-address-info--wrapper"
class="webform-address--wrapper fieldgroup form-composite webform-composite-hidden-title js-webform-type-webform-address webform-type-webform-address js-form-item form-item js-form-wrapper form-wrapper">
<legend>
<span class="visually-hidden fieldset-legend">Address</span>
</legend>
<div class="fieldset-wrapper">
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-address-info-address form-item-address-info-address">
<label for="edit-address-info-address">Address 1</label>
<input data-drupal-selector="edit-address-info-address" data-msg-maxlength="Address 1 field has a maximum length of 255." type="text" id="edit-address-info-address" name="address_info[address]" value="" size="60" maxlength="255"
placeholder="Street 1" class="form-text">
</div>
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-address-info-address-2 form-item-address-info-address-2">
<label for="edit-address-info-address-2">Address 2</label>
<input data-drupal-selector="edit-address-info-address-2" data-msg-maxlength="Address 2 field has a maximum length of 255." type="text" id="edit-address-info-address-2" name="address_info[address_2]" value="" size="60" maxlength="255"
placeholder="Street 2" class="form-text">
</div>
<div class="js-form-item form-item js-form-type-textfield form-type-textfield js-form-item-address-info-city form-item-address-info-city">
<label for="edit-address-info-city">City</label>
<input data-drupal-selector="edit-address-info-city" data-msg-maxlength="City field has a maximum length of 255." type="text" id="edit-address-info-city" name="address_info[city]" value="" size="60" maxlength="255" placeholder="City"
class="form-text">
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-address-info-state-province form-item-address-info-state-province">
<label for="edit-address-info-state-province">State</label>
<select data-placeholder="State" data-drupal-selector="edit-address-info-state-province" id="edit-address-info-state-province" name="address_info[state_province]" class="form-select">
<option value="" selected="selected">State</option>
<option value="Alabama">Alabama</option>
<option value="Alaska">Alaska</option>
<option value="American Samoa">American Samoa</option>
<option value="Arizona">Arizona</option>
<option value="Arkansas">Arkansas</option>
<option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option>
<option value="Armed Forces Americas">Armed Forces Americas</option>
<option value="Armed Forces Pacific">Armed Forces Pacific</option>
<option value="California">California</option>
<option value="Colorado">Colorado</option>
<option value="Connecticut">Connecticut</option>
<option value="Delaware">Delaware</option>
<option value="District of Columbia">District of Columbia</option>
<option value="Federated States of Micronesia">Federated States of Micronesia</option>
<option value="Florida">Florida</option>
<option value="Georgia">Georgia</option>
<option value="Guam">Guam</option>
<option value="Hawaii">Hawaii</option>
<option value="Idaho">Idaho</option>
<option value="Illinois">Illinois</option>
<option value="Indiana">Indiana</option>
<option value="Iowa">Iowa</option>
<option value="Kansas">Kansas</option>
<option value="Kentucky">Kentucky</option>
<option value="Louisiana">Louisiana</option>
<option value="Maine">Maine</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Maryland">Maryland</option>
<option value="Massachusetts">Massachusetts</option>
<option value="Michigan">Michigan</option>
<option value="Minnesota">Minnesota</option>
<option value="Mississippi">Mississippi</option>
<option value="Missouri">Missouri</option>
<option value="Montana">Montana</option>
<option value="Nebraska">Nebraska</option>
<option value="Nevada">Nevada</option>
<option value="New Hampshire">New Hampshire</option>
<option value="New Jersey">New Jersey</option>
<option value="New Mexico">New Mexico</option>
<option value="New York">New York</option>
<option value="North Carolina">North Carolina</option>
<option value="North Dakota">North Dakota</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="Ohio">Ohio</option>
<option value="Oklahoma">Oklahoma</option>
<option value="Oregon">Oregon</option>
<option value="Palau">Palau</option>
<option value="Pennsylvania">Pennsylvania</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Rhode Island">Rhode Island</option>
<option value="South Carolina">South Carolina</option>
<option value="South Dakota">South Dakota</option>
<option value="Tennessee">Tennessee</option>
<option value="Texas">Texas</option>
<option value="Utah">Utah</option>
<option value="Vermont">Vermont</option>
<option value="Virgin Islands">Virgin Islands</option>
<option value="Virginia">Virginia</option>
<option value="Washington">Washington</option>
<option value="West Virginia">West Virginia</option>
<option value="Wisconsin">Wisconsin</option>
<option value="Wyoming">Wyoming</option>
<option value="Alberta">Alberta</option>
<option value="British Columbia">British Columbia</option>
<option value="Manitoba">Manitoba</option>
<option value="New Brunswick">New Brunswick</option>
<option value="Newfoundland and Labrador">Newfoundland and Labrador</option>
<option value="Nova Scotia">Nova Scotia</option>
<option value="Northwest Territories">Northwest Territories</option>
<option value="Nunavut">Nunavut</option>
<option value="Ontario">Ontario</option>
<option value="Prince Edward Island">Prince Edward Island</option>
<option value="Quebec">Quebec</option>
<option value="Saskatchewan">Saskatchewan</option>
<option value="Yukon">Yukon</option>
</select>
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-address-info-country form-item-address-info-country">
<label for="edit-address-info-country">Country</label>
<select data-placeholder="Country" data-drupal-selector="edit-address-info-country" id="edit-address-info-country" name="address_info[country]" class="form-select">
<option value="" selected="selected">Country</option>
<option value="Afghanistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antarctica">Antarctica</option>
<option value="Antigua & Barbuda">Antigua & Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Ascension Island">Ascension Island</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bosnia & Herzegovina">Bosnia & Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Bouvet Island">Bouvet Island</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Territory">British Indian Ocean Territory</option>
<option value="British Virgin Islands">British Virgin Islands</option>
<option value="Brunei">Brunei</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Canary Islands">Canary Islands</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Caribbean Netherlands">Caribbean Netherlands</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Ceuta & Melilla">Ceuta & Melilla</option>
<option value="Chad">Chad</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Clipperton Island">Clipperton Island</option>
<option value="Cocos (Keeling) Islands">Cocos (Keeling) Islands</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo - Brazzaville">Congo - Brazzaville</option>
<option value="Congo - Kinshasa">Congo - Kinshasa</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaçao">Curaçao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czechia">Czechia</option>
<option value="Côte d’Ivoire">Côte d’Ivoire</option>
<option value="Denmark">Denmark</option>
<option value="Diego Garcia">Diego Garcia</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Eswatini">Eswatini</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Territories">French Southern Territories</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guernsey">Guernsey</option>
<option value="Guinea">Guinea</option>
<option value="Guinea-Bissau">Guinea-Bissau</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Heard & McDonald Islands">Heard & McDonald Islands</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong SAR China">Hong Kong SAR China</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jersey">Jersey</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Kosovo">Kosovo</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos">Laos</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macao SAR China">Macao SAR China</option>
<option value="Madagascar">Madagascar</option>
<option value="Malawi">Malawi</option>
<option value="Malaysia">Malaysia</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Micronesia">Micronesia</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montenegro">Montenegro</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar (Burma)">Myanmar (Burma)</option>
<option value="Namibia">Namibia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherlands">Netherlands</option>
<option value="Netherlands Antilles">Netherlands Antilles</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Northern Mariana Islands">Northern Mariana Islands</option>
<option value="North Korea">North Korea</option>
<option value="North Macedonia">North Macedonia</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Outlying Oceania">Outlying Oceania</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau">Palau</option>
<option value="Palestinian Territories">Palestinian Territories</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Philippines">Philippines</option>
<option value="Pitcairn Islands">Pitcairn Islands</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Romania">Romania</option>
<option value="Russia">Russia</option>
<option value="Rwanda">Rwanda</option>
<option value="Réunion">Réunion</option>
<option value="Samoa">Samoa</option>
<option value="San Marino">San Marino</option>
<option value="Sark">Sark</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Sint Maarten">Sint Maarten</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="South Georgia & South Sandwich Islands">South Georgia & South Sandwich Islands</option>
<option value="South Korea">South Korea</option>
<option value="South Sudan">South Sudan</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="St. Barthélemy">St. Barthélemy</option>
<option value="St. Helena">St. Helena</option>
<option value="St. Kitts & Nevis">St. Kitts & Nevis</option>
<option value="St. Lucia">St. Lucia</option>
<option value="St. Martin">St. Martin</option>
<option value="St. Pierre & Miquelon">St. Pierre & Miquelon</option>
<option value="St. Vincent & Grenadines">St. Vincent & Grenadines</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Svalbard & Jan Mayen">Svalbard & Jan Mayen</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="São Tomé & Príncipe">São Tomé & Príncipe</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="Timor-Leste">Timor-Leste</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad & Tobago">Trinidad & Tobago</option>
<option value="Tristan da Cunha">Tristan da Cunha</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks & Caicos Islands">Turks & Caicos Islands</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Türkiye">Türkiye</option>
<option value="U.S. Outlying Islands">U.S. Outlying Islands</option>
<option value="U.S. Virgin Islands">U.S. Virgin Islands</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Emirates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States">United States</option>
<option value="Uruguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican City">Vatican City</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Wallis & Futuna">Wallis & Futuna</option>
<option value="Western Sahara">Western Sahara</option>
<option value="Yemen">Yemen</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
<option value="Åland Islands">Åland Islands</option>
</select>
</div>
</div>
</fieldset>
</div>
</section>
<section data-drupal-selector="edit-personal-information" data-title="Personal Information" data-webform-key="personal_information" id="edit-personal-information" class="js-form-wrapper form-wrapper webform-card">
<h2 class="webform-card-title">Personal Information</h2>
<div class="webform-card-wrapper">
<div class="js-form-item form-item js-form-type-tel form-type-tel js-form-item-phone-number form-item-phone-number">
<label for="edit-phone-number">Phone number</label>
<input data-drupal-selector="edit-phone-number" data-msg-maxlength="Phone number field has a maximum length of 128." type="tel" id="edit-phone-number" name="phone_number" value="" size="30" maxlength="128" placeholder="xxx-xxx-xxxx"
class="form-tel">
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-are-you-a-veteran form-item-are-you-a-veteran">
<label for="edit-are-you-a-veteran">Are you a veteran?</label>
<select data-drupal-selector="edit-are-you-a-veteran" id="edit-are-you-a-veteran" name="are_you_a_veteran" class="form-select">
<option value="" selected="selected">Please select response</option>
<option value="Yes">Yes</option>
<option value="No">No</option>
<option value="My loved one with PD is a Veteran">My loved one with PD is a Veteran</option>
</select>
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-which-language-would-you-prefer-to-hear-from-us-in form-item-which-language-would-you-prefer-to-hear-from-us-in">
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we recommend selecting “both" to stay best informed on the Foundation's work and the latest in PD news.</div>
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<select data-drupal-selector="edit-which-language-would-you-prefer-to-hear-from-us-in" aria-describedby="edit-which-language-would-you-prefer-to-hear-from-us-in--description" id="edit-which-language-would-you-prefer-to-hear-from-us-in"
name="which_language_would_you_prefer_to_hear_from_us_in" class="form-select">
<option value="" selected="selected">Please select response</option>
<option value="English">English</option>
<option value="Spanish">Spanish</option>
<option value="Both English and Spanish">Both English and Spanish</option>
</select>
</div>
<div class="js-form-item form-item js-form-type-select form-type-select js-form-item-how-did-you-hear-about-the-parkinson-s-foundation form-item-how-did-you-hear-about-the-parkinson-s-foundation">
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<option value="" selected="selected">Please select response</option>
<option value="Parkinson's Foundation Website">Parkinson's Foundation Website</option>
<option value="Parkinson's Foundation Conference, Event, or Meeting">Parkinson's Foundation Conference, Event, or Meeting</option>
<option value="Parkinson's Foundation Email">Parkinson's Foundation Email</option>
<option value="Parkinson's Foundation Helpline">Parkinson's Foundation Helpline</option>
<option value="Parkinson's Foundation Brochure, Flyer or Postcard">Parkinson's Foundation Brochure, Flyer or Postcard</option>
<option value="Parkinson's Foundation Staff">Parkinson's Foundation Staff</option>
<option value="Facebook/Twitter/YouTube/LinkedIn/Instagram">Facebook/Twitter/YouTube/LinkedIn/Instagram</option>
<option value="Support Group">Support Group</option>
<option value="Google">Google</option>
<option value="AARP">AARP</option>
<option value="Friend, Family or Coworker">Friend, Family or Coworker</option>
<option value="Veterans Administration / Local Veterans Organization">Veterans Administration / Local Veterans Organization</option>
<option value="Doctor's office">Doctor's office</option>
<option value="YMCA">YMCA</option>
<option value="Parkinson's Foundation Moving Day">Parkinson's Foundation Moving Day</option>
<option value="Other">Other</option>
</select>
</div>
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* Understanding Parkinson’s
* Understanding Parkinson’s
* What is Parkinson's?
* 10 Early Signs
* Causes
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* Non-Movement Symptoms
* Getting Diagnosed
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* Understanding Parkinson’s
Understanding Parkinson’s
There is a lot to know about Parkinson's disease. Learn about symptoms, how
it is diagnosed and what treatment options are available.
* Understanding Parkinson’s
* What is Parkinson's?
* 10 Early Signs
* Causes
* Movement Symptoms
* Non-Movement Symptoms
* Getting Diagnosed
* Statistics
* Living with Parkinson’s
Living with Parkinson’s
While living with PD can be challenging, there are many things you can do to
maintain and improve your quality of life and live well with Parkinson's
disease.
* Living With Parkinson’s
* New to Parkinson's
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empower you.
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Advancing Research
Our research has led to breakthroughs in treatment and improved care that
bring hope to the entire Parkinson's community.
* Advancing Research
* Finding A Cure
* Our Research
* Join A Study
* Advocate for Research
* For Researchers
* Parkinson’s Virtual Biotech
* How You Can Help
How You Can Help
There are many ways you can support the fight against Parkinson’s. Whatever
form your gift takes, you can be confident that it goes toward providing
crucial resources for those affected by this disease.
* How You Can Help
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* Support Our Campaign
* Fundraise
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BREADCRUMB
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* Events
Educational Events
RECOGNIZE & RESPOND TO PARKINSON'S PSYCHOSIS
Virtual ( Zoom )
June 5, 2024
1:00 pm to 2:00 pm EST
Free
REGISTER FOR VIRTUAL
WELLNESS WEDNESDAY
Not everyone with Parkinson’s will experience psychosis, but it can be
frightening if you don’t know what’s happening or how to handle it. It is
important to be able to recognize these symptoms if they occur. Learn what to
watch for and know how to respond to these behavior changes to ensure the safety
and well-being of you and your loved one.
SPEAKERS
Heshan J. Fernado, PhD, ABPP-CN
Board Certified in Clinical Neuropsychology
Corewell Health, A Parkinson's Foundation Comprehensive Care Center
Ruth Maidens
Health Promotion Facilitator, Parkinson & Movement Disorders Program
Kaye Edmonton Clinic, Alberta Health Services, A Parkinson's Foundation Center
of Excellence
There is no charge to attend, but registration is required.
CONTACT US
Crista Ellis
PDHealth@Parkinson.org
(828) 352-1079
PD Health @ Home is presented by the Light of Day Foundation, whose generosity
has made this programming possible.
This is a virtual program, taking place live, using the online Zoom platform.
Instructions on joining the webinar are provided after registering.
UPCOMING EVENTS
Educational Events
MINDFULNESS MONDAYS - WORKING WITH DISCOMFORT
Join us every Monday as our expert speaker leads you in guided relaxation
techniques to help boost brain power and reduce stress. Whether this is your
first mindfulness Monday, or you are a returning participant, these sessions are
created with the intention of including everyone. There will be time for
questions following the practice.
June 3, 2024
Virtual
REGISTER FOR VIRTUAL
Educational Events
PARKINSON'S 101: WHAT YOU AND YOUR FAMILY SHOULD KNOW
This program offers an introduction and basic overview of Parkinson’s disease.
June 4, 2024
Young Harris, GA
REGISTER FOR IN-PERSON
Educational Events
RECOGNIZE & RESPOND TO PARKINSON'S PSYCHOSIS
Learn what to watch for and know how to respond to these behavior changes to
ensure the safety and well-being of you and your loved one.
June 5, 2024
Virtual
REGISTER FOR VIRTUAL
View All
PD HEALTH @ HOME
Join us for new, weekly virtual wellness programs! Take part in one or all of
our events that cover: mindfulness, interviews with experts and guided exercise.
VIEW EVENTS
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Email Address
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FL: 200 SE 1st Street, Ste 800, Miami, FL 33131, USA
NY: 1359 Broadway, Ste 1509, New York, NY 10018, USA
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BASIC INFO
First Name
Last Name
Send me communications from my local chapter
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ZIP
PARKINSON'S CONNECTION
What is your Parkinson's connection? Please select responsePerson with
PDSpouse/PartnerParent has / had PDOther family of person with PDFriend of
person with PDHealthcare ProfessionalOther
Are you involved with the person with Parkinson's care? Please select
responseYesNo
Please share the year of Parkinson's diagnosis:
ADDRESS
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(Keeling) IslandsColombiaComorosCongo - BrazzavilleCongo - KinshasaCook
IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d’IvoireDenmarkDiego
GarciaDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial
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TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard
& McDonald IslandsHondurasHong Kong SAR
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ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorth
KoreaNorth MacedoniaNorwayOmanOutlying OceaniaPakistanPalauPalestinian
TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn
IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSamoaSan
MarinoSarkSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint
MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia & South
Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. HelenaSt.
Kitts & NevisSt. LuciaSt. MartinSt. Pierre & MiquelonSt. Vincent &
GrenadinesSudanSurinameSvalbard & Jan MayenSwedenSwitzerlandSyriaSão Tomé &
PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad &
TobagoTristan da CunhaTunisiaTurkmenistanTurks & Caicos IslandsTuvaluTürkiyeU.S.
Outlying IslandsU.S. Virgin IslandsUgandaUkraineUnited Arab EmiratesUnited
KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis &
FutunaWestern SaharaYemenZambiaZimbabweÅland Islands
PERSONAL INFORMATION
Phone number
Are you a veteran? Please select responseYesNoMy loved one with PD is a Veteran
Which language would you prefer to hear from us in?
*Please note that not all content is available in both languages. If you are
interested in receiving Spanish communications, we recommend selecting “both" to
stay best informed on the Foundation's work and the latest in PD news.
Please select responseEnglishSpanishBoth English and Spanish
How did you hear about the Parkinson's Foundation? Please select
responseParkinson's Foundation WebsiteParkinson's Foundation Conference, Event,
or MeetingParkinson's Foundation EmailParkinson's Foundation HelplineParkinson's
Foundation Brochure, Flyer or PostcardParkinson's Foundation
StaffFacebook/Twitter/YouTube/LinkedIn/InstagramSupport GroupGoogleAARPFriend,
Family or CoworkerVeterans Administration / Local Veterans OrganizationDoctor's
officeYMCAParkinson's Foundation Moving DayOther