Brain Health Registry

Registry Consent

I consent to my name being placed in a registry of research volunteers who may be contacted by Cogniciti to participate in various research projects.

My name and other personal information collected by Cogniciti will be kept confidential. Being part of the registry in no way binds me to participate in any particular project. My personal information (name, email address, gender, location, health history and Cogniciti Brain Assessment results) will only be released to a research organization with my express consent, in relation to a particular research project.

I agree that Cogniciti may contact me by email if a) a specific research project comes up that fits my profile, and b) to provide information and updates about the registry. If a particular study interests me I will confirm that interest to Cogniciti. Upon providing that confirmation I agree that Cogniciti may provide my personal information to the research organization so that a researcher can contact me to obtain my consent to participate in the study. My participation is strictly voluntary. My personal information will remain in Cogniciti’s registry so that I will be eligible for future research projects.

My relationship with Cogniciti for a particular study ends once I agree to be contacted by the research organization. I acknowledge that Cogniciti is not responsible for the conduct of any research. By identifying potential volunteer opportunities for me, Cogniciti is not endorsing any particular study or organization.

At any time and for any reason I may request that my name be removed from the registry by emailing [email protected].

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