Physician's First Name (required)
Physician's Last Name (required)
Institution/Practice Name (required)
Address Line 1 (required)
Address Line 2
ZIP Code (required)
Office Phone (required)
How many dystonia patients do you see in a month? (required)
What forms of dystonia do you treat?
Acquired (Secondary) DystoniaBlepharospasmCervical Dystonia/Spasmodic TorticollisDopa-Responsive DystoniaFocal Limb DystoniaFunctional DystoniaGeneralized - Childhood/Adolescent OnsetGeneralized - Adult OnsetMyoclonus-DystoniaOromandibular/Embouchure DystoniaParoxysmal Dystonia/DyskinesiasPrimary Torsion DystoniaRapid-Onset Dystonia-ParkinsonismSpasmodic Dysphonia/Laryngeal DystoniaWriters Cramp/Hand DystoniaTardive Dyskinesias/DystoniaX-Linked Dystonia-Parkinsonism
Do you treat children? (required)
Do you offer telemedicine appointments? (required)
Do you wish to join the DMRF mailing list? (required)
How You Can Help
There are many benefits to joining a dystonia support group. Find the support group nearest you and enjoy the rewards.
You can connect with others in the dystonia community who are committed to making a difference. Getting involved is empowering.
The Dystonia Medical Research Foundation (DMRF) has stood up for the dystonia community since 1976. Join us in our global effort to find a cure.
Copyright ©2022 Dystonia Medical Research Foundation | All Rights Reserved.