Join A Study - Centurion Neuroscience Research

Join a Study - Pre-Screening

Pre-Screening Questionnaire

Are you interested in participating in clinical research?

Centurion Neuroscience Research is currently seeking eligible volunteers over the age of 18 for upcoming clinical trials related to Bipolar Disorder, Depression, Social Anxiety Disorder, and Schizophrenia.

This short pre-screening questionnaire asks you to provide demographic and medical information to help us quickly determine if you might be eligible. Our staff will contact you for a phone-screen if eligible.

Your privacy is of utmost importance. Your information will be kept confidential and only shared with study personnel if needed.

Which Study are you interested in?

First Name *

Last Name *

Email *

Phone

Birth Date

Zip Code

Gender

Do you currently have, or have you ever had, any of the following? *

Anxiety Disorders

Bipolar Disorders

Depression

Schizophrenia

Other

None

If Other Please Specify:

Are you willing to take investigational medication as a part of a trial? *

Yes

How did you hear about us?