Get Michigan Alzheimer's Disease Research Center Participant ... - Med Umich

Filling out the Michigan Alzheimer's Disease Research Center participant information form is an essential step in participating in important Alzheimer's research. This guide provides you with clear instructions on completing the form accurately and efficiently online.

Follow the steps to successfully complete the participant information form.

1. Press the ‘Get Form’ button to access the participant information form and open it in your preferred online editor.
2. Start with today’s date, filling in the date in the provided space. Then, enter your full name where indicated.
3. Select how you heard about the Michigan Alzheimer's Disease Research Center by checking the appropriate box or providing the name of the event in the 'Other' section.
4. Provide the name of the research volunteer and complete your address, including city, state, and zip code.
5. Enter your contact information, including your phone number and email address.
6. Fill in your date of birth and specify your age.
7. Indicate your gender by selecting the appropriate option.
8. Answer whether you want to serve as a healthy volunteer or if you have concerns about changes in your memory.
9. If you have memory concerns, specify when you began noticing these changes and if you have consulted a physician about it.
10. Indicate whether you receive medical care at the University of Michigan and your consent for accessing your medical information should it be necessary for study participation.
11. Complete the medical history section by answering yes or no to each medical condition listed, and provide details as needed.
12. List any current medications you are taking.
13. Indicate whether you live alone and whether you have someone who could serve as a study partner.
14. Answer questions about your ability to undergo specific procedures like MRI scans or blood draws.
15. Lastly, express your interest in participating in PET studies by selecting yes or no.
16. Once you have completed all sections, ensure your information is accurate, and save your changes. You can then download, print, or share the form as necessary.

Take the next step toward participation by completing the document online today!