Parkinson’s disease symptom checklist.

Filling out this form will help you and your doctor determine if you may have Parkinson’s disease, or if it may be time to adjust your PD medication.

Check all that apply:

I have trouble using a spoon or a fork

Sometimes it’s hard to breathe

There are times when I shake uncontrollably

I have trouble moving in the early morning

Getting up from a sitting position can be difficult

Sometimes I shuffle when I walk

The effects of my medication don’t last as long as they did

I have abdominal pain

I experience drenching sweats

Sometimes, my muscles spasm