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Life Extension Clinical Research

Study ID: CL042

Are you a family member or caregiver that is completing this form on behalf of the volunteer?

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By clicking "next" you are submitting the information of this page to Life Extension Clinical Research, Inc. (LECR) and you give your consent to the following: (i) LECR will retain the information on this page; (ii) LECR may contact you regarding this study by telephone or e-mail; and (iii) if you do not qualify for this study, LECR may contact you by telephone or e-mail about future studies for which you may be eligible. Your information will not be shared and will only be accessed by LECR personnel. Please contact us at (866) 517-4536 with any questions.