Parkinson's Pre-screener

I am aged*

30-80 years of age

I am one of the following*

I have been diagnosed with Parkinson's disease
I have symptoms of Parkinson's disease and am awaiting a formal diagnosis
I have symptoms suggestive of Parkinson's disease (i.e. tremors, muscle stiffness and slowness of movement)

Do you suffer from any of the following?*

Thank you very much for your interest in our research, unfortunately you have an exclusionary medical condition/medication and therefore are not be eligible for studies currently running at the clinic.

Do you take any of the following medications*

Thank you very much for your interest in our research, unfortunately you have an exclusionary medical condition/medication and therefore are not be eligible for studies currently running at the clinic.

PLEASE NOTE TAKING PART IN OUR RESEARCH MAY REQUIRE THE FOLLOWING

Some studies require a study partner who can attend appointments with you and observe your progress during the course of the study.

Clinical research may involve participating in a trial over a period of time and require taking study medication/placebo.

Name*

First Last

Email*

Postcode*

Phone*

Date of Birth*

How did you hear about us?*

Best time to call?*

Opt in?

I agree to receive future emails from NeuroClin Glasgow
No

Terms and conditions*

I have read and accept the Terms and conditions

Read the Terms and conditions

Register to take part in one of our studies.

Parkinson's
Pre-screener