Clinical Research Volunteer Form

Thank you for your interest in participating in clinical research at the Parkinson's Institute. 

Participating in research means joining a group of individuals with a common goal of advancing the understanding of disease cause, the distribution and burden of disease, and the development of disease prevention strategies.

Many of our studies focus on specific groups of people, or those in particular geographic areas. We also need volunteers that do not have neurological disease. Without the involvement of healthy individuals to serve as control participants, many of our research studies would simply not be possible.

By completing this form, you are requesting we contact you in regards to clincal research conducted at the Parkinson's Institute. The information you give us will be kept confidential in accordance with our Privacy Policy


 

First Name *
Last Name *
Phone *
Email address
Re-enter email address
 
Please contact me by
 Email  Phone  Either
 
 
Preferred Day/Time if contact by phone (eg. "weekdays, Tues pm")
Comments (do not include any private information)


Thank you for your interest in clinical research at the Parkinson's Institute.  A Clinical Research coordinator will contact you soon.

675 Almanor Avenue | Sunnyvale, CA 94085
408.734.2800 main | 408.734.8455 fax (Main) | 408.734.9208 fax (Clinic Secure)