Meniere's Australia Information and Resources about Meniere's Disease

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Help us to help you – join Meniere's Australia today!
To join MA you need to complete a membership application form and post it to us together with your fee payment.

Member survey

If you are joining MA - or you are already a member - please take a few minutes to complete the following online member survey. All information is optional. Any information you can provide will help us to improve and better target our services to members. We will not pass on your personal information to other parties without your consent.

Title	(Mr/Mrs/Ms/Miss/Dr)
First name
Surname
Phone(home)
Year of birth
Current occupation
Previous occupation

How long have you been a member of Meniere's Australia?
I have just applied for membership
Less than 1 year
1-5 years
over 5 years

I joined/want to join Meniere's Australia because:
I have Meniere's disease
A family member or friend has Meniere's
I have a professional interest in Meniere's

Fill out the following sections only if you have Meniere's disease. If you have only filled in the above section, please remember to click the 'Send' button at the bottom of this form.
What symptoms do you experience?
Vertigo (dizziness)
Hearing loss
Tinnitus (abnormal noise in the ear)
Sensitivity to sound
Anxiety/emotional issues
Other symptoms (please specify)

I am under the care of:
GP (local doctor)
Ear Nose & Throat (ENT) Specialist
Neurologist
Other care (please specify)

I have had surgery for Meniere's:
No
Yes

Thanks for providing us with this valuable information.

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