In 2010 CPT conducted a pilot survey into how Parkinson's symptoms affect Quality of Life. The pilot survey highlighted how non-motor symptoms have a significant impact on Quality of Life. This new survey builds upon the insights from the pilot survey to further investigate the non-motor aspects of Parkinson's.

This survey has been developed with a fantastic steering committee. With many thanks to Dr Peter Fletcher, Dr Helen Roberts, Dr Karen Green, Alison Leake, Jane Price, Jayesh Shah, Steve Grundy, UCB Pharma and Red Door Communications.

Thank you so much for your help in completing this survey.

* 1. Where do you live?

* 2. Please tell us your age

* 3. Are you male or female?

* 4. How long has it been since you were first diagnosed with Parkinson's?

* 5. Do you have any additional underlying conditions?

* 6. What medications are you currently taking on a regular basis? (please list)

* 7. Do you consider your Parkinson's to be

* 8. Which of the following do you usually see with regards to the management of your Parkinson's? (please tick all that apply)

* 9. In the past year, how many times have you seen a nurse specialist face to face about your Parkinson's?

* 10. In the last year, how many times have you had other types of contact including phone and email with a nurse or specialist about your Parkinson's?