In these tough times, HA is offering this very popular patient-centered and community-based 5-week course in exchange for a minimum donation of $50 to HA! But, space will be LIMITED, in order to ensure that everyone can participate in discussion. To guarantee your spot please complete our brief questionnaire that will allow us to get to know you better and ensure that class participants bring a diversity of perspectives that all can learn from. Course registration will be emailed to selected participants.

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* 1. Contact Information

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* 2. What is your connection to Hydrocephalus Association?

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* 3. Which race/ethnicity best describes you? (Please choose only one.)

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* 4. What is your age?

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* 7. If you are unable to donate $50, please indicate this here. This will not affect your chances of being invited to register.

Click submit to complete our questionnaire. We will be in touch to let you know if you have been selected as a participant.

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