Registration form Slow-SPEED study

If you are interested in participating in the Slow-SPEED study or if you want to know more about the Slow-SPEED study, please fill in the following information. Our research team will then be in contact with you.

Personal Information

First name

Last name

E-mail

Telephone number

How old are you (in years) ?

You need to be 50 years or older to participate in this study.

Are you aware of future health risks related to either the LRRK2 or GBA1 gene?

YesNo

During the study, you may encounter information about potential health risks linked to the LRRK2 or GBA1 gene. Would you like to know more about these risks?

YesNo

By clicking the ‘Next page’ button, you may receive information about potential health risks related to the LRRK2 and GBA1 genes through the questions in this form. Participation in this study will also provide additional insights into these risks. If you do not wish to learn more about these health risks, you cannot proceed.

Study questions

Do you carry a variant in LRRK2 or GBA1?

LRRK2 variantGBA1 variantBoth LRRK2 and GBA1 variantI do not know

Do you experience any of the following symptoms (check all that apply)?

Acting out dreams while asleep (e.g., punching, flailing arms, making running movements)Having fewer than or equal to three bowel movements per weekA reduced ability to smell

To schedule a phone call, we would like to reach out to you first. Do you prefer to be contacted via e-mail or phone ?

E-mailPhone

by checking this box, you consent to being contacted by the research teams at Radboudumc and University of Rochester for this study

Yes, I consentNo, I do not consent

We cannot process your information without your consent

It is not possible to continue due to a previous question:

During the study, you may encounter information about potential health risks linked to the LRRK2 or GBA1 gene. Would you like to know more about these risks?"

Answer: "No"