1. Newborn Brain Research Survey and Advocate List

The purpose of this survey is to identify individuals who wish to promote research to better understand causes of newborn brain injury and design therapies for infants and children with neurological disorders.

* 1. Why do you feel strongly about promoting research into causes and new treatments for newborn neurological injuries? Check all that apply. In the "other" box please give a detailed explanation of how your family has been affected.

* 2. Do you think the United States federal government (e.g., the National Institutes of Health(NIH), National Science Foundation) should fund more research on causes and treatments for infant neurological injuries?

* 3. Are you willing to join an advocate list to promote research into causes and treatments for newborn neurological injuries?
If so, please fill out the fields below. By filling out this form, you agree to let the Newborn Brain Research Institute at the University of California San Francisco use your (1) name and (2) demographic information on funding petitions to government officials. We will not make your e-mail address public.
We will also use this list internally to build a contact database for emailing interested parties regarding clinical trial enrollment status.