Become a NeuroNEXT Affiliate

NeuroNEXT at UC Davis is establishing a network of affiliate neurologists/neurosurgeons and organizations to participate in NeuroNEXT studies. As a NeuroNEXT affiliate, you will receive occasional e-mails about upcoming clinical trials, especially regarding the need for study subjects. Affiliate status is open to neurologists/neurosurgeons and organizations in the California, Nevada and Oregon regions.

Note: The information received via this form will be used only for informational purposes related to the NeuroNEXT consortium and will not be provided to any other party or organization.

Your name:*
Practice/Organization name:*
Mailing address:*
E-mail address:*	(example: john.doe@ucdmc.ucdavis.edu)
Special clinical interests (e.g., pediatric epilepsy):

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Contact Information

U.S. NeuroNEXT