Research Registry

Pledge Information
Basic Information
Use abbreviated state name (Ex. New York = NY)
If your service ENDED before 9/11/2001, select "Pre 9/11"
Exposure Information
This section asks about your history of brain trauma exposure. Complete this section to the best of your ability regarding your knowledge of the patient's brain injury history. You do not need to have experienced brain trauma in order to sign up for the Clinical Research Registry or Brain Donation Registry. We encourage you to sign up regardless of your brain trauma history.
Referral Information