Atlanta Center for Medical Research
Who Is ACMR Clinical Research Our Experience The Facility Sponsors Employment Contact Us
Join a Study at ACMR

If you are interested in a study or would like more information, please fill out the following information and someone will contact you as soon as possible.

Join A Study
Do you want to participate in or learn more about our clinical trials? Schedule a free assessment to see if
you qualify.

Apply Online

Or Call: 404.881.5800

 
First Name *:
Last Name *:
Age *:
Sex *:
Home Phone :
Work Phone :
Can we leave a message? 
Email Address :
Diagnosis :
Other :
Medications :
 
Current/Past Medical Conditions :

(Check all that apply)  

Asthma/Allergies
Seizures
Diabetes
Heart Conditions/Stroke
Head Trauma/Loss of Consciousness
Liver/Kidney Disease
Surgeries
HIV
Drug/Alcohol Abuse
Hepatitis
Tuberculosis