For new Parkinson's contestants who wish to participate in an apprenticeship and accompaniment project

If you are interested in being accompanied by a companion, fill out the questionnaire at the bottom of this page.

For more information, you can call the hotline 054 6125043

Thank you for your cooperation

Questionnaire for trainee

"*" Mandatory field inductor

Name*

First name Last Name

Phone*

ID.

Email*

settlement

Marital Status*

# of kids

Date of diagnosis of the disease

Year of Birth

Association member

Main occupation in the past

Current main occupation

Parkinson's disease*

Paitot Parkinson's Association in Israel*

Rights of chronic patients*

Self-management of the disease*

Support groups*

Orientation on the association's website*

You can choose several challenges:*

Additional challenges