Simufilam Trial Participant Family Advocacy Contact Form
We are looking for patients on Cassava Trials that want to advocate for continued access to the drug. Additionally, we are looking for patients that willing to be vocal and advocate to get the drug to Alzheimer's patients. Particularly, we want patients that are willing to advocate to find a way to extend the open label while we wait for regulatory approval. My Name is Matt Nachtrab and I am the one leading this effort. If you are worried that this is spam, reach out to me at @mattnachtrab on twitter using messaging. You can also email me at mnachtrab@cureguardian.org. If you go to cureguadian.org you can see it is me that started the entity. As long as we are honest, do not share specific data from the trial, we are not trying to coerce or alter the results of trial, it is okay to get public and advocate publicly for access to the drug. This is a patient advocacy group and is WHOLLY SEPARATE FROM CASSAVA.
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
What Trial is the patient in?
*
Please Select
Phase 2 Extended Open Label
RETHINK 12 month phase 3
REFOCUS 18 Month phase 3
RETHINK Extended Open Label
REFOCUS Extended Open Label
I don't know
What is Your Relationship to the Patient
*
Trial Site
What was your patient number in the trial
How long have they been in trials in MONTHS
*
Were you on placebo or treatment during the blinded phase of your trial? If you don't know, please ask your trial site. HIGHLY RECOMMEND YOU GET ALL RECORDS THEY WILL GIVE YOU
Treatment
Placebo
What do you feel about this statement: The Trial Results Aligned with My Experience with the Drug
Strongly Agree
Agree
Disagree
Strongly Disagree
How important is it to you that your patient maintain access to simufilam?
*
1 - Vitally important
2 - Prefer to remain on treatment
3 - Not important
Tell us about your observation of the patient's health while in the trial. Stories about tasks or surprising behavior changes are encouraged.
Were there parts of your trial that you noticed a change like the drug started working or did not
Please have Cure Guardian Contact me
Yes
No
Will you be willing to sign a petition to government agencies to keep access to Simufilam?
*
Yes
No
Are you and your patient willing to participate in any of the following to help improve the awareness of the potential benifits of the Drug and support for EXTENDED OPEN LABEL TO KEEP ACCESS TO DRUG
Video Documentary
Written Endorsement
Sign Petitions of support for extended open label
Be a witness at trials or other government related proceedings against people involved with the development of the drug
Please keep me updated on the advocacy for the treatment.
*
Yes
No
Submit
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