Please complete this screening form if you would like to participate in the Digital Brain Library project. You may also complete the form on behalf of a family member or friend if you are the next of kin or you hold durable power of attorney (see definitions below). The form will provide us with the necessary information to evaluate candidates based on our study criteria. Once the screening form has been submitted, we will review your information and contact you within 2 working days by email or by phone. If the potential donor is eligible to participate in the study, we will send you the necessary study materials, including consent forms and research questionnaires. All information will be kept confidential and used exclusively for screening by trained staff at The Brain Observatory. If your case is not eligible for the study, we shall let you know and all information entered via the form will be permanently erased. Thank you for your interest in the Digital Brain Library Project and The Brain Observatory.