Every three seconds, someone in the world develops dementia1.

Now's the time to act.


The Global Alzheimer's Platform Foundation (GAP) knows that when it comes to Alzheimer's disease, there's no time to lose.

Join us as we work to #StopALZ

In partnership with BlackDoctor.org, the Global Alzheimer’s Platform Foundation® (GAP) is conducting a virtual pre-screener to quickly evaluate those who may be eligible to participate in our Alzheimer’s disease clinical trial, Bio-Hermes-002. Below are the IRB approved questions that will be sent to a participating clinical trial site in your area to, with your consent, contact you if you are eligible or would like to learn more about your brain health. If you have questions about the Bio-Hermes-002 study, you can find the study information and some of the participating sites here.

This form will ask you several questions relating to your race, age, and health and take approximately 5 minutes to complete. These answers are not required to be answered at this moment but will provide important insight to our team. You can stop completing the form at any time and your responses will not be recorded unless submitted. Your answers will only be used to help decide if you may be eligible to participate in an Alzheimer’s disease clinical trial. Answering these questions does NOT mean you consent to participating or being enrolled in a clinical trial, only that you agree to be contacted by a representative to learn more.





    What race best describes you?

    Are you Hispanic or Latino?

    Are you between 60 to 90 years of age?

    Have you experienced a stroke or seizure within the last 12 months?

    Have you had cancer within the past 5 years?

    Do you have someone (a companion, friend, or relative) who could accompany you to appointments?

    Who completed this form?*

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