Evaluation for Referral

Individuals interested in becoming a CJD, rapidly progressive dementia, or related disorder research participant need be screened for eligibility. To expedite this process, please follow the steps listed below.

1. Complete the Potential Research Subject Intake Form. This form can be printed and mailed along with your medical records (see below).
2. Please request a copy of your medical records related to your illness (inpatient and outpatient) from your primary care physician and other health care providers (e.g. neurologist, psychologist). These medical records should include lab results, diagnostic reports, clinical notes and imaging. If possible, please send all MRI images on a CD. Records can be sent to:
   
   Attn: Dr. Michael Geschwind
   UCSF Memory and Aging Center
   350 Parnassus Ave Ste 905 / Box 1207
   San Francisco CA 94143-1207
3. If you are referred by a physician and if possible, please have the physician send us a referral letter along with your medical records. The referral letter should describe why you are being referred and a synopsis of your condition.

Once we review your medical records, a research coordinator will call you and either set up a research visit or refer you to a different specialist. During this process, we ask that you do not contact multiple members of our research team as doing so can significantly delay the review process.

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