MDA Next Steps Seminars Interest Form

MDA’s Next Steps Seminars provide small group learning for the community at critical life stages including receiving a new diagnosis of a neuromuscular disease and transition to adulthood for youth living with a neuromuscular disease. These seminars are offered on an on-going basis. Once you complete this registration form, our team will be in touch with you regarding the next date for the seminar that is relevant to you/your family.

Contact Info:

First Name

Last Name

Address

City

State

Zip

Phone Number

Additional Information:

I am:

Please share your role in the neuromuscular community

Diagnosis/Diagnosis of loved one:

What year did you/your loved one receive a diagnosis of neuromuscular disease?

If you are a parent/caregiver of a child under 18 who is living with a neuromuscular disease, how old is your child?

Which Next Steps Seminar are you interested in attending?

How did you hear about the Next Steps Seminars?

I am 18+ and agree to MDA's terms & conditions and privacy policy. (https://www.mda.org/about-mda-privacy-policy)

I agree

I understand and accept that my personal data will be collected as a result of my registration and participation in connection with this MDA Community Education program and will be used for future MDA communications.

I accept

All Next Steps Seminar attendees must be a member of MDA to participate. By completing this registration form, you and your child will be automatically registered as a member with MDA. There is no fee associated with your MDA membership. For more information, please visit mda.org/join-mda

Contact Information