Parkinson’s Foundation

The Parkinson's Foundation strives to improve care and advance research toward a cure for PD. But we can’t do it without you! The information we gather will help us continue to strengthen our community and better engage with supporters, like you, who care deeply about our mission.

Step 1 of 13 – Q1

This field is for validation purposes and should be left unchanged.

1) Do you feel well informed about the Parkinson's Foundation and its mission to advance research, improve care, and empower those with Parkinson's?

Yes

Don’t know

Why do you feel this way?

2) What best describes your connection to Parkinson’s disease? Please select all that apply.

I have Parkinson’s disease.

My spouse/partner has/had Parkinson’s disease.

My parent has/had Parkinson’s disease.

Another family member has/had Parkinson’s disease.

I am the friend of a person with Parkinson’s disease.

I am a healthcare professional.

I am a care partner for someone with Parkinson’s disease.

Other

2a) Other – Please specify:

Please specify:

What was your year of diagnosis?

3) In what ways have you engaged with the Parkinson's Foundation? Please select all that apply.

I donate to the Parkinson’s Foundation.

I am a beneficiary of the Parkinson’s Foundation’s work.

A loved one is the beneficiary of the Parkinson’s Foundation’s work.

I volunteer or work with the Parkinson’s Foundation.

I have been to Parkinson’s Foundation events.

I follow the Parkinson’s Foundation on social media.

I have visited the Parkinson’s Foundation website.

Other

3a) Other – Please specify:

Please specify:

3b) How frequently do you engage with the Parkinson's Foundation?

How frequently do you engage with the Parkinson’s Foundation?

Weekly

Monthly

Every few months

Yearly

Rarely or never

Other

3b-i) Other – Please specify:

Please specify:

4) We like to send supporters like you occasional emails with updates including videos, stories, and information about how we are making an impact on your behalf. Would you like to receive these updates? (You can opt-out at any time).

Yes, I want to receive occasional emails with updates.

Not at this time.

5) Which aspect of the Parkinson's Foundation's work is most meaningful to you?

Advancing cutting-edge research towards a cure

Ensuring better outcomes by improving standards and access to care

Expanding education and resources to empower the Parkinson’s community

Other

Please specify:

Which of the following statements best applies to you?

I want to support the best programs and research that is local to me.

I want to support the best programs and research, no matter where they occur.

6) Was there an influential person in your life who inspired your appreciation of the Parkinson's Foundation?

Yes

6a) If yes, please indicate their relationship to you.

If yes, please indicate their relationship to you.

Parent/grandparent

Spouse/partner/significant other

Child/children

Other family member

Friend

Teacher

Other

6a-i) Other – Please specify:

Please specify:

7) When thinking about future generations, how important is it to you that the Parkinson's Foundation continues to find optimal treatment options and even a cure for the disease?

Of utmost importance

Very important

Somewhat important

Not very important

Not important at all

8) Supporters often recognize the need to support the Parkinson’s Foundation in order to improve care and advance research towards a cure. Would you consider furthering our work in any of the following ways?

I already have	I am likely	I am somewhat likely	I am not likely

Donating online with a credit card

I already have

I am likely

I am somewhat likely

I am not likely

Mailing a check

I already have

I am likely

I am somewhat likely

I am not likely

Talking to a gift officer about my giving intentions

I already have

I am likely

I am somewhat likely

I am not likely

Making a recurring contribution

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Donor-Advised Fund

I already have

I am likely

I am somewhat likely

I am not likely

Donating from a Family Foundation

I already have

I am likely

I am somewhat likely

I am not likely

Giving appreciated assets (such as personal or business stocks or bonds, land or rental real estate, etc.)

I already have

I am likely

I am somewhat likely

I am not likely

Giving property (such as jewelry, artwork or a car)

I already have

I am likely

I am somewhat likely

I am not likely

Making an additional one-time gift to support a special initiative that will increase the Foundation's effectiveness and impact

I already have

I am likely

I am somewhat likely

I am not likely

Transferring a portion of my IRA account to the Parkinson's Foundation (Qualified Charitable Distribution)

I already have

I am likely

I am somewhat likely

I am not likely

Making a charitable gift that provides a lifetime income to me or my loved ones

I already have

I am likely

I am somewhat likely

I am not likely

9) Many people like to include a gift to charity in their will or estate plan to support causes that are important in their life. Would you consider including a gift to the Parkinson's Foundation to improve the lives of those living with the disease?

I have included a gift for the Parkinson’s Foundation in my will, trust, or by beneficiary designation.

I am interested in making this type of gift to the Parkinson’s Foundation.

Not now, but in the future I would definitely be interested in making this type of gift to the Parkinson’s Foundation.

Not now, but in the future I might possibly be interested in making this type of gift to the Parkinson’s Foundation.

I am not interested in this type of gift.

9a) Please tell us about your legacy gift:

Please tell us about your legacy gift:

I planned this gift in honor or in memory of someone.

I would like this gift to go to a specific purpose.

The Parkinson’s Foundation may use this gift where it will do the most good.

9a-i) Please provide the name of and/or association with this person:

Please provide the name of and/or association with this person:

9a-ii) Please describe the intended purpose:

Please describe the intended purpose:

Guides

Please send me more information to help with my decision.

10) How does the Parkinson's Foundation rank in comparison to other non-profits you may support?

My top choice for charitable giving

Near the top of my list

Middle of my list

Bottom of my list

Not on my list

10a) Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of the Parkinson's Foundation?

Do you have any friends/colleagues/family members with similar interests who would consider supporting the mission and vision of the Parkinson’s Foundation?

Yes

10a-i) Please let us know the most convenient way to connect:

Please let us know the most convenient way to connect:

I would like to introduce the person(s) to the Parkinson’s Foundation on my own.

I would like the Parkinson’s Foundation to provide me with resources to share with the person(s).

11) We would love to hear your story. If you would like, please share a special memory or experience with the Parkinson's Foundation.

12) About You (optional)

Age

Under 40

40 – 49

50 – 59

60 – 69

70 – 79

80 – 89

90+

Gender: How do you publicly self-identify?

Female

Male

Transgender

Nonbinary or non-conforming

Different identity

Prefer not to specify

Please specify:

Sexual Orientation: How do you publicly self-identify?

Heterosexual or straight

Gay, lesbian or bisexual (or other sexual orientation within the LGBTQ+ community)

Different identity

Prefer not to specify

Please specify:

What is your marital status?

Married or Domestic Partnership

Single

Divorced

Widowed

Separated

Which of the following best describes your family?

No children

One child

Two or more children

Please tell us the highest level of education you completed:

Less than a high school diploma

High school graduate or equivalent

Some college

Associate’s degree

Bachelor’s degree

Advanced degree

Please select the option(s) that best describes your professional life.

Working full time

Working part time

Retiring within 5 years

Retired

Volunteering

Board member for a nonprofit

Business owner or entrepreneur

Self-employed

Other

Profession:

Where do you serve as a board member?

Are you a Veteran?

Yes

My loved one with PD is a Veteran

The following questions are optional.

Responses to these questions will help the Foundation further understand who we are reaching and how best to serve the Parkinson’s community.

Are you of Hispanic/Latino origin?

Which of the following best describes your race?

Which language would you prefer to hear from us in?

*Please note that not all content is available in both languages; if you are interested in receiving Spanish communications, we recommend selecting “Both” to stay best informed on the Foundation’s work and the latest in PD news.

Please check the box below if you would like to update your contact information.

I would like to update my contact information.

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My preferred method of communication is:

Phone call

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