Caregiver Support Series "*" indicates required fields What type of dementia has your loved one been diagnosed with? * Required Alzheimer’s Disease Vascular Dementia Lewy Body Dementia Frontotemporal Dementia Mixed Other Unknown Enter required information below. * Required First Last Email * Required Phone * RequiredResidence County * RequiredBentonWashingtonMadisonBaxterBooneCarrollIzardMarionNewtonSearcyStoneotherGender * RequiredMaleFemaleOtherRace * RequiredAfrican-AmericanAmerican IndianAsian/Pacific IslanderCaucasianHispanicMiddle EasternOtherProfession * RequiredPublic/CommunityDieticianMedical StudentNursingNursing Home AdministrationParaprofessionalPatientPhysical TherapyPhysicianResidentSocial WorkStudentHow did you learn of this program?My Center on Aging (the Schmieding Center)FacebookWebsiteWord of MouthMy Healthcare Provider (e.g., doctor, nurse, etc.)OtherHow did you learn about this program?Registration for * Required(Wednesdays only.Choose a series to attend) May 6 to May 27 from 2:00pm to 4:00pm This field is hidden when viewing the formI consent, per above terms, to the use of my image by UAMS for program and event promotion * Required Yes No SCSHE This field is hidden when viewing the formI want to receive email notice about other Schmieding Center events * Required Yes No SCSHE This field is hidden when viewing the formMy knowledge about caregiving is * Required Excellent Good Fair Poor SCSHE This field is hidden when viewing the formMy understanding of dementia is * Required Excellent Good Fair Poor SCSHE This field is hidden when viewing the formMy confidence in being a caregiver is * Required Excellent Good Fair Poor SCSHE This field is hidden when viewing the formMy understanding of where to find help and resources is * Required Excellent Good Fair Poor SCSHE This field is hidden when viewing the formComments(Why did you register, benefits you anticipate, etc.)
