Screening Form To evaluate your eligibility for the study, please answer the next following 4 questions to the best of your knowledge. Please note you have to be at least 30 years old to join our study. Date of Birth (dd/mm/yyyy) Screening Form Q1: What is your age? > 65 45-65 < 45 Screening Form Q2: What is your education level? Secondary school and above Primary school and below Screening Form Q3: Any family history of dementia (first degree*)? *First degree means parents, siblings or children Yes No Screening Form Q4: Within the last 5 years, have you been prescribed with treatment for any of these conditions? Diabetes Mellitus High Cholesterol High Blood Pressure None of the above Thank You! Thank you for filling up the screening form. As there is an overwhelming number of people signing up for our study, there will not be any acknowledgement sent to you to state you have registered for the study. We will contact you when we have an available slot for you. Thank you for your patience. Previous Next
