COMPLETE THIS SHORT SURVEY TO LEARN MORE ABOUT OUR NO COST MEMORY SCREENS

Please tell us about yourself so that we can find suitable study locations near you. All the information you complete will remain private.

First Name

Last Name

Primary Phone

Mobile Phone

Address

Apt. / Ste.

City

Zip Code

We need this information calculate your body mass index (BMI).

Height (Feet)

Height (Inches)

Weight (lbs)

Date of Birth

Gender

Male Female Other

Please choose the race and/or ethnicity that describes yourself. Choose all that apply:

Do you have memory loss symptoms?

Yes No Unsure

Have you been diagnosed with Alzheimer's by a doctor?

Yes No

Your privacy is important to us. Please confirm that you have reviewed our Privacy Policy and agree to the Terms of Use.

Yes, I have reviewed the privacy policy and agree to terms of use

Okay to receive text messages

Read “Is Grandma Home?”

by Crusey and Avila

View this resource for those going through a memory loss journey by clicking through the arrows on the right side of the comic, or download the PDF link here.

Participate in a Study in San Diego and Rancho Bernardo, CA

Volunteer for medical research to learn more about your condition, gain access to new treatments and medications, and contribute to medical advancements.

Have a Question/Comment?

Part of the ERG Network of Research Sites

Together we are one of the largest research organizations in the nation focusing on the conduct of clinical trials for healthy individuals and those suffering from psychiatric disorders, pain, Alzheimer’s, hepatic, renal and other debilitating diseases.

STUDIES ARE ENROLLING NOW!

MEMORY LOSS

For those who are struggling with memory loss, a memory screen is a step in the right direction to keeping their minds healthy. Apply for a FREE memory screen today!

Narcolepsy

If you or someone you love has been struggling with excessive daytime sleepiness and cataplexy (muscle weakness) related to narcolepsy, a clinical trial may be an option.