Contact Us

We are standing by for you. Please call us at: 602.239.6500.

Our phone line is open from 9 am to 4:30 pm Monday through Friday.

You may also send us an Email at registryinfo@azalz.org and include your name and phone number. We will contact you within one week.

If you prefer, you can mail your request to us at:

Alzheimer's Research Registry
901 E. Willetta St.
Phoenix, AZ 85006 You may also use the form below to contact us.

*First Name:
*Last Name:
*Address:
*City:
*State:	Select One Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Guam Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington DC West Virginia Wisconsin Wyoming FPO AE FPO AA FPO AP
*Zip:
*Phone Number:	i.e.###-###-####
*E-Mail Address:
*Date of Birth:	i.e.(mm/dd/yyyy)
If you are interested in receiving Registry materials on behalf of someone else, please include the name and date of birth of that person
First Name:
Last Name:
Date of Birth:		ie.(mm/dd/yyyy)
Please indicate the types of studies you are interested in participating in:
Studies for people without memory problems
Studies for people with memory problems