Defeat PD

Programs

Defeat PD Registration

WELCOME! Thank you for your interest in Defeat PD at the YMCA of Greater Birmingham.

Below you will find four documents (each link will take you to each document). The last item is to set up a Y membership. For the duration of your participation in this program you and your household will receive a complimentary Y membership! 

Once I have received all of your forms we will schedule your movement assessment. Please move through the steps in the following order:

1. Quality of Life Questionnaire:  Include the same primary contact and personal information you supplied for the previous form. Answer all questions completely.
2. Health History Questionnaire: Include the same primary contact and personal information you supplied for the previous form. Answer all questions completely, where applicable.
3. Beck’s Depression Inventory: Include reliable contact information. Answer all questions. Be sure to watch videos, when applicable. Follow the prompts to submit when complete.
4. Waiver: As a required step, you will be signing a participation waiver. Please click the link to the waiver and either print it out, sign and bring with you to your movement assessment or for your convenience we will have a hard copy for you to sign at your movement assessment.
5. YMCA Membership:  If you are not already a paying Y member, please click the link to sign-up and receive a complimentary membership for the duration of the program! If you are a paying member, your membership will be automatically updated to complimentary status.

If you have any questions about these forms or difficulty completing any of the steps, please do not hesitate to contact me. Thanks so much, and we look forward to working together with you!

Andrea Pindroh
Parkinson’s Coordinator
Email me at apindroh@ymcabham.org