Membership is free and available to qualified Movement Disorder Professionals in Canada. Please enable JavaScript in your browser to complete this form.Name *FirstLastProfessional Affiliation *Clinic or Clinical Program / Hospital or Academic InstitutionCity *Province *SelectAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecYukonEmail *Profession *NeurologistNeurosurgeonPhysician Other Specialty (please specify below)Surgeon Other Specialty (please specify below)NursePhysiotherapistOccupational Therapist Speech & Language Therapist PsychologistSocial Worker DieticianNon-Clinician Scientist OtherOther Professional SpecialtiesWhat is your professional relation to the Movement Disorders sub-specialty? *Do you have any specific interest within the Movement Disorders sub-specialty? *Submit