Parkinson's Virtual Wellness Class for Voice
Thank you for your interest in My Voice's Parkinson's Virtual Wellness Class for Voice.

This is a free 30-minute virtual class that is offered to people with Parkinson's. See below for details and fill out the survey to see if you are a candidate for the class!

We (virtually) come together every Tuesday from 3-3:30 PM EST to review the speech exercises, get to know everyone, and share resources for Parkinson's.

Please complete the secure form below to request access to this engaging class!


Find out more about speech therapy for Parkinson's and schedule a phone call to discuss your options here: MyVoiceTherapy.com/parkinsons-voice
Sign in to Google to save your progress. Learn more
Email *
Thank you for your interest! This secure form is following My Voice Speech Therapy LLC's HIPAA and HI-TECH policy and procedures. 

Please include your first and/or last name for identification purposes:
*
This class is available for those who have previous engagement with Parkinson's voice exercises. Have you completed voice exercises before? *
This class is virtual. We utilize the secure platform Google Meet which does not need a special download but it does need some of the following:
(check which situation applies to you)
*
Required
The video link will be sent to you via email Tuesday mornings. Do you consent for My Voice Speech Therapy to send the video link and as well as other general information and resources meant for the general public to your email?  *
Please enter your email address: *
This Tuesday Group is not considered Speech Therapy and is only offered as general information. Please consult with your medical team before starting an exercise routine.  *
Please provide additional information about yoruself below or 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of My Voice Speech Therapy.

Does this form look suspicious? Report