Are your dystonia symptoms under control?
Take the Survey. You Could Feel Better.

DRMF Canada is dedicated to helping you live well with dystonia. Your responses to these questions will help us to continue to offer you quality programs and services - PLUS - You could WIN one of THREE VISA Gift Cards.  For contest rules click here. 

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* 1. Do you experience pain because of your dystonia?

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* 2. If Yes, how much pain do you experience?

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* 3. Have you noticed sleeping worse or being more often awake at night since you have been diagnosed with dystonia (1 or more times per week)?

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* 4. Do you find that you socialize less or with less pleasure because of your dystonia?

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* 5. Do you ever miss work or school because of your dystonia?

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* 6. Have you been feeling more tired or fatigued during the day since being diagnosed with dystonia?

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* 7. Do you suffer from anxiety or depression since you have been diagnosed with dystonia?

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* 8. Please provide details on the treatments you are currently using or have previously tried:

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* 9. Is there anything else you would like to share? 

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* 10. If you’d like to be entered into a draw to win a VISA gift card please provide your contact information:

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