Professional Directory Opt-in Form

The MdDS Foundation is updating its database of healthcare providers. If your practice diagnoses or provides care to patients with Mal de Débarquement Syndrome, please complete this form. Your listing will appear when our website is updated in June.

If you are an MdDS patient and your doctor would like to be included on our list, please share this page with him or her.

If your browser does not display the form, simply follow this link: