Subscribe to receive opportunities to put your dementia positive action plan into action! We are looking forward to partnering with you! Would you kindly share some information that will help us understand what opportunities might interest you? Your First Name(Required)Your Last Name(Required) What is your relationship to dementia? I am living with dementia or cognitive change I am a care partner I am helping to support someone living with dementia I want to prevent dementia I don't have a relationship to dementia I am a professional that supports people living with dementia Unsure Prefer not to answer What opportunities interest you most? Check all that apply. All Dementia Positive Opportunities Events Advocacy Opportunities Joining the Empowering Partnership Network Educational Opportunities Unsure How would you like us to follow up with you?I prefer communicating by: Phone Email I don't have a preference May we have your contact information to follow up with you?Phone Number(Required)Email(Required)AddressCityStateZip How did you learn about LiveWell? A family member/ friend told me about LiveWell My family member/ friend is a current or former resident My doctor recommended I connect with LiveWell I heard about LiveWell on CT Public Radio I found LiveWell through a Google search I saw an ad online I attended a Human Forever Event I'm not sure Do you have any questions?
