Update Contact Information for the NCRAD Study

Thank you for participating in the National Centralized Repository for Alzheimer's Disease and Related Dementias (NCRAD) Family Study. If you have a change in your contact information, please let us know. We appreciate being able to stay in touch with you!

Electronic Submission (Preferred Method)

  1. Completely fill out the form below
  2. Click "Submit" when complete

Submission by US Mail

  1. Print the downloadable form and fill it out by hand.
  2. Mail the completed form to:
    The National Centralized Repository for Alzheimer's Disease and Related Dementias
    Indiana University School of Medicine
    Division of Hereditary Genomics
    410 W. 10th Street, HS 4000
    Indianapolis, IN 46202-3002

Submission by Fax

  1. Print the downloadable form and fill it out by hand.
  2. Fax the completed form to (317) 278-1100
  1. Print this page and fill out the form
  2. Mail the completed form to:
    The National Centralized Repository for Alzheimer's Disease and Related Dementias
    Indiana University School of Medicine
    Division of Hereditary Genomics
    410 W. 10th Street, HS 4000
    Indianapolis, IN 46202-3002

The National Institute of Health, which sponsors many of our studies, requires that we report ethnicity and race for all study participants. Please mark ONE box in the table below. Start by choosing your ethnicity Hispanic or Latino or Not Hispanic or Latino. Then under either the Hispanic or Latino or the Not Hispanic or Latino column choose your race from the selections under the heading Race.

Ethnicity
Race Hispanic or Latino Not Hispanic or Latino
American Indian/Alaska Native
Asian
Native Hawaiian or Other Pacific Islander
Black or African American
White
More Than One Race