PEER KYNNECTIONS Registration Page

Fill out the form below and a PEER KYNNECTIONS staff member will contact you to help schedule the call.

I am a

Person with PD

Care Partner, relative, or friend

First name

Last name

Email address

Phone number

I prefer to be contacted via:

Phone

The best time to contact me is:

Morning

Afternoon

Evening

Zip Code

By submitting this form, I agree and acknowledge that the information I’ve provided voluntarily will be used only by Sunovion and its contracted third parties to:

contact me regarding the PEER KYNNECTIONS program
leave me a voicemail or to send me an email that contains my personal health information
provide helpful information on treatments, services, and for marketing and informational purposes

I understand that Sunovion will not sell or transfer my name to any third party for their marketing use.

Please see the most recent version of our privacy policy , which may change from time to time.