Register to Participate

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As part of the National Population Study of Neurological Conditions, several projects will seek input from people living with a neurological condition, informal caregivers, health care professionals and service providers/Allied health professionals. If you are interested in participating, please register below. Please note that this is only an indication of interest on your part, not a formal commitment. You will have the opportunity to consider what is involved with each project before making any decisions. By registering below, you are simply giving the NHCC permission to share your information with the appropriate research teams so they can contact you.

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Join the Canadian Brain Community
Register Today to Stay Connected

Are you a: *

Person Living with a Neurological Condition

Caregiver or Family Member

Researcher

Healthcare Professional

Service Provider / Allied Health Professional

NGO Staff or Volunteer

Which organization are you associated with?:

What is your neurological condition?:

How long since your diagnosis?:

What is your loved one's neurological diagnosis?:

What is your area of expertise (field of research)?:

Which institution(s) are you affiliated with?:

What is your role?:

Do you work in an institutional or community setting?: - None -InstitutionalCommunity

Do you work in an urban or rural community?: - None -RuralUrban

What service do you provide?:

Would you like to participate in the National Study of Neurological Conditions?:

Yes

No

Name: *

Email: *

Postal Code: *

Province: *

Country: *

* denotes a required field.