STEP 2 of 3:

Progress 33%

Please Answer the Questions Below.


Have you been diagnosed with Alzheimer's or another Cognitive Decline condition?

CONTINUE  

Are you in an assisted living facility?

CONTINUE  

Are you experiencing symptoms related to cognitive decline or is there a specific reason you are interested in attending?

CONTINUE  

Are you a caregiver with the power of attorney?

CONTINUE  

Can your family member attend our event?

On a scale of 1-10, with 10 being the highest, how motivated are you to get your condition under control?

In accordance with federal HIPAA laws, any health data provided here will not be stored or used for any other purpose.  All information provided will be deleted.

Unfortunately you’ve missed too many events. You may still attend an event, however it costs $97.

Please call Dr. Shumard’s office at 858.564.7081 to make this payment and sign up for the event.

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