Stroke Patient Clinical Trial Contact Form

Patient Interest Form

A Randomized Pilot Study Assessing Vagus Nerve Stimulation (VNS) During Rehabilitation for Improved Upper Limb Motor Function after Stroke.

Do you fulfill the following criteria?
1. I am 22 to 80 years of age
2. I had a stroke at least 9-months ago but not more than ten years ago.
3. I have some arm and hand movement difficulties, but can use my hand some (the site will perform specific assessments to check if you meet the entry criteria.
4. I don’t have any talking or cognitive or thinking difficulties that would impact my ability to be in the study.
5. I don’t have any significant sensory problems.
6. I don’t have any aspiration or swallowing difficulties.
7. I am reasonably healthy other than my stroke and am ok to have surgery.
8. I don’t have any hand spasticity.

There are other criteria that will be checked at screening, but If you meet ALL of the criteria above, please provide your contact information below and a representative from the study site will reach out to you for an initial screening call.

1. Please provide your information below.

First Name *This question is required.

Last Name *This question is required.

City of Residence *This question is required.

State of Residence *This question is required.

Zip Code / Postal Code *This question is required.

Email Address *This question is required.

Phone Number *This question is required.

2. How do you prefer to be contacted?