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Watch Dr. Jaime Perales Puchalt discuss the CudiaTEXT study
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To become part of the MyAlliance network and receive MyAlliance Monday Highlights, please provide the information below and click submit. We appreciate your interest in learning more about what we have to offer at the University of Kansas Alzheimer's Disease Research Center (KU ADRC). The information you provide here will remain confidential, and is being retained for the sole purpose of matching you to the information, support, events, and studies we provide at the ADRC. We look forward to connecting with you!
By connecting with the University of Kansas Alzheimer's Disease Research Center , you're helping to advance groundbreaking research and shape better care for our communities. Connecting with us is an important step toward us finding better ways to prevent and treat Alzheimer's disease and other dementias. Please complete the form below to get started. If you indicate interest in research, a member of our team will follow up with you. Opportunities are available for individuals both with and without diagnosed memory changes.
Please note that the information you provide here is collected and kept as part of our process to best match you to the services and studies offered at the center.
Any information you share is safe, secure, and used only for research purposes. We never share your data outside of our trusted research team.
Only your name and one form of communication are required
Today M-D-Y
Are you interested in a specific research study that you recently became aware of?
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What is the name of the research study you are interested in?
Do you provide emotional and/or physical support to a relative/friend with memory and thinking problems?
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What types of research studies are you interested in?
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What most recently caused you to reach out to the KU Alzheimer's Disease Research Center with an interest in participating in research?
Family or Friend Health Care Professional (MD, RN, etc.) Newspaper, Magazine, or Podcast TV or Radio Website/Internet Social Media (Facebook, Twitter, etc.) Brochure, Flyer, or Poster Public Presentation/Event (In-person) Mail/Letter or email MyAlliance Sponsor portal Webinar KU ADRC Staff CES Guide
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Resources for brain health and dementia caregiving, research, and prevention Resources as above, but for those diagnosed with a dementia Resources for Down Syndrome Community
How did you learn about MyAlliance?
Attended a virtual or live education program At an ADRC or community event/meeting From a friend or family member Through research participation From a health care professional or ADRC staff member Social media Received a text message TV, radio, podcast or newspaper Brochure, poster, flyer Received a mailing or email Juntos Other
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Memory Status Questions
The following questions are about the memory status of person on whose behalf you are calling. If you would like to be considered for research, answer the questions for yourself, otherwise answer the questions with your loved one's information.
Do you feel that you (they) are experiencing any memory or thinking changes?
Yes No Maybe/I don't know
Please indicate what changes in memory, thinking or behavior are being experienced, if any. (click all that apply)
Decreased or poor judgment
Less interest in hobbies/activities
Repeating the same things over and over (questions, stories, or statements)
Trouble learning how to use a tool appliance or gadget (e.g. computer, microwave, remote control)
Confusion with time or place
Difficulty handling financial affairs? (e.g., balancing checkbook or paying bills)
Trouble remembering appointments
Daily problems with memory or difficulty completing familiar task
Decreased or poor judgment
Less interest in hobbies/activities
Repeating the same things over and over (questions, stories, or statements)
Trouble learning how to use a tool appliance or gadget (e.g. computer, microwave, remote control)
Confusion with time or place
Difficulty handling financial affairs? (e.g., balancing checkbook or paying bills)
Trouble remembering appointments
Daily problems with memory or difficulty completing familiar task
Have these concerns been mentioned to a doctor?
Yes No
Have you (they) been diagnosed with a memory impairment?
(For example: Mild Cognitive Impairment, Alzheimer's Disease, Dementia, Lewy Body Disease, Frontotemporal Dementia, etc.)
Yes No
Are you (they) currently taking prescribed memory medications?
Yes No
Are you (they) interested in our Down Syndrome studies?
Yes No
Other notes, comments or concerns
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Any information you share is safe, secure, and used only for research purposes. We never share your data outside of our trusted research team.
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Thank you! A member of our research team will contact you as soon as possible to discuss the current research opportunities available.
**Please note: Many of our studies limit participants to active participation in only one study at a time. If you are already enrolled in one of our research studies, we encourage you to first contact your study coordinator to discuss further, prior to completing this form. Thank you for understanding.**