Phone: 818/705-7450
Fax: 818/705-7454
E-mail encino@priresearch.com
Click here for driving directions
Please fill out the form below if you are interested in participating in a research study:
First Name: Last Name:
Street Address:
City: State: California Zip Code:
Phone Number:
Best time to call? Please select one: Morning Afternoon Evening
E-mail:
Study you are interested in participating in: Please select study: Anxiety Depression Social Anxiety Smoking Cessation Memory Loss/Alzheimers Migraine Headaches Persistent Stuttering (ADHD) Attention Deficit Hyperactivity Disorder
Where did you hear about us? Please select one: Google Radio T.V. Craig's List CenterWatch Newspaper Newsletter Other
I prefer information to be mailed to the above-referenced street address: Yes No
I prefer information to be e-mailed to the above-referenced e-mail address: Yes No
Please contact me at the phone number listed above to schedule an appointment: Yes No