Enter your physicians information

We are putting together a database of physicians who treat myositis. Your input is greatly appreciated. 

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* 1. Name of Physician

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* 2. Physician Contact

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* 3. Speciality

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* 4. For which form of myositis does this doctor treat you?

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* 5. How you would rank this doctor in terms of knowledge/experience with your disease?

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* 6. How you would rank this doctor in terms of listening to your needs?

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* 7. Add any additional notes about the physician you are listing

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* 8. Your contact information (optional)

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