Peer Support Circle Signup
Join our supportive community and share your interests
Zoom
Meetings are on a monthly basis
on the last Monday of the Month at 10:30am EST
Your Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
I have access to ZOOM conferencing (required)
*
Yes
No but I will set it up
Please test your Microphone and Sound prior to joining the meeting using this link to test your Video and Sound:
https://zoom.us/test
You can use this link multiple times by ending the test call and clicking on the link again.
Support Topics You’re Interested In
Medications & treatments
Coping with stress
Healthy lifestyle habits
Memory tools & routines
Emotional support
I’m not sure yet
Other
Consent
*
I agree to receive information about the Virtual Peer Support Circle.
Acknowledge that the meetings will be recorded and may be used for publication David's Alzheimer's website site.
Submit
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