Research

Home > Research > Intake Form

Questionnaire for Potential Subjects

(Required) indicates a required field

Please fill out this brief questionnaire so that we can better answer your questions. A representative from Shepherd Research will be in contact with you to discuss studies that may be appropriate and available to you.

If SCI, please indicate which of the following best describes you:

If ABI, what best describes you:

If MS, please indicate what form of MS you have:

Do you have any other significant medical issues or other diagnoses that we should be aware of, such as high blood pressure, diabetes, cardiac pacemaker, stroke, cardiac disease, skin breakdown, etc.?

Is there a specific area of research that you are interested in, such as drug studies, device studies, cellular studies vs. curative studies or therapy intervention studies?

If you checked "Yes," please tell us what areas of research you are interested in:

Intake Form

Sign up here to participate in our research programs.

Annual Report

Read our latest research report.

Read more >

Research at Shepherd

Watch video >

SCI Research Fellowship

Download the brochure for more information.

Read more >
YouTube Flickr Joint Commission CARF MedGift

Contact Us

Shepherd Center
2020 Peachtree Road NW
Atlanta, GA
30309-1465
Tel. 404-352-2020
Get in touch

Latest Tweet

Stay safe this holiday #weekend. Don't #dive or drive #distracted. Wear a #helmet. http://t.co/BNjm4IRdji

# 12 hours ago
Click here to follow us on Twitter
© Copyright 2013 Shepherd Center
Terms & Conditions Privacy Policy
English En Espanol
Site by Piszko