Online Screening

Please kindly share the following details for an initial free online screening clinical assessment:

Full Name Of The Patient

Age Of The Patient

Gender Of The Patient

Occupation Of The Patient

Best Mobile Contact Number For The Patient

City

Complete Address:

Brief Medical Concern

Doctor Notes If Any

Medical Reports If Any

Laboratory Tests If Any

Brain Imaging If Any

Also Share A Patient Video Showing Movement Problem While Sitting and While Walking

Full Name Of the Caregiver Accompanying The Patien

Mobile Number Of The Caregiver

Occupation Of The Caregiver

How did you hear about us? (Google / Facebook / Meta Ads / YouTube/ TikTok/ What’s App/ Family Members/ Friends/ Other)

All of this information is required to provide initial free screening clinical assessment for your neurological case.

Thank you

Best Regards
Parkinson’s MD Care Team