Thank you for showing interest in our study! Our research study is investigating medication and psychological treatments for alcohol use disorders. Please fill out the form below so we can contact you to see whether this program is likely to be a good match for you. All the information that you provide will be kept confidential.
What is your name?
What is your phone number?
Is that your cell, home, or work number?
Would it be okay for our study staff to identify ourselves as from the Center for Anxiety and Related Disorders in a voicemail?
Keep in mind that email is not the most secure means of communication compared to phone contact.
Would it be okay to contact you by email and identify ourselves as the Center for Anxiety?
What is your email address?
What is your preferred method of contact?
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