Casting Call: Share your Parkinson’s story, help the Parkinson’s community.

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* First Name

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* Last Name

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* Phone Number

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* Email Address

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* City

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* State

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* Age

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* How many years have you been living with Parkinson’s disease (PD)?

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* We are looking for people who are not letting their PD stop them from doing activities and hobbies they love. What is the activity/hobby you are most passionate about and still participating in despite your PD?

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* Tell us why you enjoy this activity/hobby, how often you do it, and if you’ve had to modify the activity/hobby because of your PD.

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* Tell us a bit about yourself. Whatever you feel comfortable sharing. Are you currently working? If not, what did you used to do for work? Partner? Children?

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* What are 3 words that people would use to describe you?

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* Choose one of the following:

I speak fluent English

I speak fluent Spanish

I speak both English and Spanish fluently

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* Are you generally available in October for filming in your area?

Yes

No

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* Are there any specific dates you are not available between October 15 and October 30?

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* Do you agree to tell your story and have it recorded for possible use in a public service commercial and/or other marketing or communications activities for Parkinson’s awareness?

Yes

No

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* Please upload a photo of yourself here.