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Screening
If you are interested
in becoming a participant in this study, you must be screened to determine
your eligibility. This screening is done via the linked form, which
you may print, fill out and mail to the Program Director:
Julian M. Stewart
MD, PhD
Suite 618 Munger Pavilion
New York Medical College
Valhalla, NY 10595
The downloaded
screening questionnaire requires postage to mail. You can also fax us a copy at
914-594-4513. You can also use Email to stewart@nymc.edu
If you are unable
to view or
print this form and still desire to find out about your eligibility,
please contact the investigators at the
above address or at stewart@nymc.edu and you will be mailed a copy.
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