PISCES III Intake Questionnaire
Thank you for your interest in the PISCES III study. The purpose of this questionnaire is to help determine if you may be eligible for further pre-screening to participate in the PISCES III study. This is the type of information we will collect and store about you in this questionnaire:
Name and contact information
Stroke information, including any remaining disabilities, and other simple questions related to your medical history
Call the PISCES III team at 1-844-707-8336
Email the PISCES III team at PISCES3@duke.edu
By clicking on the “Yes I Agree” button below you consent to participate in the PISCES III Intake Questionnaire as detailed above. If you do not wish to participate please click the “No I Disagree” button. You may stop the registration process at any time. If you choose to stop, we will not use any of the information you have provided.
(Registration takes approximately 10 minutes to complete.)