This will take about 3 minutes to complete. Tell us a little bit about yourself, and we will connect you with a mentor. 
For questions, call 1-855-776-8966 (M-F: 8 AM-5 PM CT).

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Which days of the week are you typically available to speak with your mentor? (Select all that apply.) *

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What time of day are you typically available to speak with your mentor? (Select all that apply.) *

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Tell us about the kind of person you are hoping to connect with. We will do our best to match you with a mentor who meets your preferences.

By submitting this form, you acknowledge that you would like to enroll in the Duopa Mentor Program, which is an AbbVie patient support program that connects you with a volunteer Mentor already using Duopa therapy. Some of the enrollment information you provided will be shared with your Mentor and Duopa program staff so that they can reach out to you and provide you with the Duopa program services.

Please be aware that phone conversations with volunteer Mentors are not monitored or recorded. AbbVie is not responsible for any statements or experiences shared by Mentors. Although Mentors are instructed not to disclose your personal information to others, including any health information that you may share, AbbVie cannot guarantee that this will not happen. Please exercise caution before discussing your personal and health information with your Mentor. You authorize AbbVie to contact you by phone (including leaving a voicemail that mentions the Duopa Peer Mentor Program), email or other means of communication and use your personal information for other business purposes by AbbVie, such as to offer you the opportunity to receive notices regarding AbbVie's products or services, to invite you to participate in surveys about AbbVie products, or to notify you about special promotions.

Additionally, your Mentor will not share anything about you with your health care provider. Your participation in the Mentor Program does NOT and is not intended to replace your relationship with your health care provider, nor is it intended to provide medical advice.

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