Dear Community Member,

Thank you for your interest in the BRAID-Alzheimer’s Conversation Circle series. This program offers a welcoming space to share your experiences while helping us better understand how to strengthen support for families and communities affected by Alzheimer’s and dementia.
Please take a few moments to complete a brief survey so we can determine your eligibility to participate.

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* 1. What is your name

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* 2. Email Address:

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* 3. Phone number

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* 4. What Borough do you work or reside?

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* 5. Are you an adult 18 or older?

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* 6. Preferred Language

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* 7. What is your experience with Alzheimer's ?

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* 8. Please select the group that fits your availability for the Zoom meeting. Participants are expected to attend all four sessions for their selected group.

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* 9. Unfortunately, I’m unavailable on these dates; however, I would appreciate being considered for future opportunities. I am interested in participating in a group focused on the following health topic(s) (check all that apply):

Thank you so much for completing the survey. Our team will contact you regarding your eligibility.

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