Find out if you may be eligible | Spring Clinical Trial

Thank you for your interest in learning more about the SPRING Clinical Trial for P. gingivalis-positive Alzheimer's disease. To determine your preliminary eligibility for participating in the trial, please answer a few questions:

1. Are you completing this for yourself or someone else?

Myself

A family member or someone I care for

2. What is the potential participant's age?

< 55 years old

55 – 80 years old

> 80 years old

3. Has a healthcare professional diagnosed you/them with Alzheimer’s disease?

Yes

No

Not sure

Another type of memory or cognitive condition

4. Which description best reflects your/their current level of memory impairment and independence?

Has memory problems but remains mostly independent

Needs some help with daily activities

Needs substantial help with most daily activities

Requires full-time care or is unable to participate in conversations

Not sure

5. Is there a family member or caregiver who knows you/them well and can attend study visits?

Yes

No

Not sure

6. How far are you/they willing and able to travel to a participating study site?

Up to 20 miles

Up to 50 miles

Up to 100 miles

Other

7. What ZIP code do you/they live in?

8. Are you/they currently participating in another clinical trial or receiving an investigational treatment?

Yes

No

Not sure

9. Are you/they willing to be contacted by a participating study site?

Yes

No

Authorization:

By submitting this form, you acknowledge and agree that the SPRING Study team and/or a participating study site may contact you regarding possible participation in the study. Please note that completion of this questionnaire does not guarantee eligibility or qualification for enrollment in the study.