Parkinson’s Disease – Age 40 Through 75


Aspen Clinical Research is currently taking part in a clinical research study investigating the effects of an add-on oral investigational medication designed to reduce the tremors associated with Parkinson’s Disease. Participants in this study must be 40 through 75 years of age.

Your first visit to the research clinic will be a screening visit. During this visit you will meet with a study coordinator to fully review study details. If you decide to participate, a more in depth assessment of your health will take place to determine your final eligibility. If you are eligible and choose to enroll, you will be required to return to our research clinic at various times for treatment and follow-up visits.

Space in the study is limited. Health insurance is not required. All clinical visits, medications, and physical exams are provided to you at no cost. You may be compensated for the time and travel involved for this study.

Please complete the form below to see if you pre-qualify for the study. All information you provide to Aspen Clinical Research will remain strictly confidential.

Disclaimer: Not all individuals that complete the on-line questionnaire will qualify for the study. An in-depth study and medical evaluation must be completed in person in order to qualify for the study.

 

Study Questionnaire

First Name (required)
Last Name (required)
Email Address
Male or Female ?
Address/Street Name
City
State
Zip
Date of Birth (DD-MM-YYYY)(required)
Primary Phone (required)

Other Phone
Best Time to Call:
Have you participated in a clinical research study at Aspen before?
Referral Source
Referral Name
Have you been diagnosed as having Parkinson's Disease? (required)
Are you currently taking an antiparkinsonian medication? (required)
Please list the name, dose, and frequency of any medications you are currently taking:

Are you interested in learning more about other studies?

Before an individual can participate in a clinical research
study, Aspen Clinical Research is required to receive study participants medical
records from their primary care physician. Would you like to expedite this
process by taking 2-3 minutes to fill out the HIPAA (Privacy Act) form after clicking
the "Send" button below? (required)

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