YES! Please sign me up for monthly newsletter emails - MUST CHECK YES IN ORDER TO SUBMIT THIS CONTACT REQUEST FORM. Alternatively, you may contact us directly at 972-4-DOCTOR for information about our studies.

Please fill out the form below to be added to our monthly email newsletter and be notified of new studies starting each month. We are privately owned and do not share information with any outside parties, and we do not bill for insurance. Your information is kept confidential. We will call to verify the information you submit on this form is accurate and to discuss our currently enrolling studies.

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How did you find out about our research clinic?
  Referral - Word of Mouth
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Studies of interest (optional)- please check the studies you would like to be notified of

*To pick more than one study hold down your Ctrl key and left mouse click.

Medical Studies
AIDS Allergy (seasonal) Canker Sores/Mouth Ulcers Carpal Tunnel Cholesterol Constipation Diabetes Diarrhea Dyspepsia Epilepsy Fibromyalgia GERD (gastroesophageal reflux disease) Heartburn Hepatitis A Hepatitis B Hepatitis C Herpes Labiales Herpes Simplex High Blood Pressure HIV Insomnia Interstitial Cystitis Irritable Bowel Syndrome Knee Pain Liver Problems Migraine Headaches Nutrition Osteopenia/Osteoporosis Osteoarthritis Overactive Bladder Pain - chronic pain PHN - Post Herpetic Neuralgia Rheumatoid Arthritis Shingles Sinusitis Seizures Stress Incontinence Ulcerative Colitis Urge Incontinence Weight Loss Other

Other:

Men's Studies
BPH (Benign Prostatic Hyperplasia) ED - Erectile Dysfunction PIN (Prostatic Intraepithelial Neoplasia) Prostate Cancer Prostate Cancer Prevention Other

Other:

Women's Studies
Bacterial Vaginosis Birth Control Breast Tenderness Endometriosis Female Sexual Arousal Disorder Fertility Heavy Menstrual Periods Menstrual Cramps Hormone Replacement Therapy HPV (Human Pappaloma Virus) PMS/PMDD Sexual Problems Yeast Infections Other

Other:

Psychiatric Studies
Alzheimer's Anorexia Anxiety Bipolar Type I Bipolar Type II Bulimia Depression Obsessive Compulsive Disorder Panic Attacks Schizophrenia/Schizoaffective Disorder Other

Other:

Addiction Studies
Stop Smoking Stop Drinking Stop using cocaine/crack Stop using methamphetamines/crystal Stop using pain killers Stop using opiates Other

Other:

Pediatric Studies
Infant formula Pediatric Allergy Pediatric Skin Fungal Infections Other

Other:

Skin Studies
Acne Athlete's Foot Cosmetic Studies Dandruff Eczema Laser Psoriasis Rosacea Seborrheic Dermatitis Skin Fungal Infections Tinea Versicolor Toenail Fungus Warts Wrinkle Reduction Other

Other:

SKINTASTIC is our PARTNER FOR MEDICAL SKIN REJUVENATION (NOT STUDY-RELATED - OFFICE VISITS REQUIRE PAYMENT FOR SERVICES RENDERED) - optional
 I would like to be contacted by SKINTASTIC in Plano or Dallas for an appointment to discuss a skincare regimen for me! SKINTASTIC specializes in state-of -the art skin solutions and wrinkle reduction like BOTOX® Cosmetic, Restylane®, Fotofacial and Microdermabrasion. THIS IS NOT STUDY-RELATED. OFFICE VISITS REQUIRE PAYMENT FOR SERVICES RENDERED. For more information, visit www.skintastic.com or call 972-620-FACE.

 Allergies? Yes! Please contact me to schedule an appointment to discuss allergy testing and treatments. This is not study related. Office visits require payment for services rendered. Dr. Jeffery Adelglass, ENT, offers hearing aides, immunotherapy for allergy relief, pollen count information and sinus surgery for your healthcare needs. For more information, visit www.entdocs.com.

NOTE: By completing and submitting this Form to us, we will better be able to Pre-Screen you for new Studies as we receive them. Your name will then automatically be placed on a List to be called for that study. All information is confidential! Please go to our Privacy Policy for more information.