PTSD Initial Survey

Please answer the following questions honestly for enrollment into the Carrick Brain Center's PTSD veteran study.
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Consent for participation in study.

You have been directed to this website for screening for a study being conducted at Carrick Brain Centers (located at 105 Decker Drive, St 120, Irving, TX 75062) on the safety and efficacy of our treatment system in veterans with treatment resistant PTSD. This study will in no way alter the treatment plan however, the study requires a pre-treatment and post-treatment psychological assessment with an independent, licensed psychologist. This study requires you to complete several surveys for six months following your treatment.

Two weeks of treatment at Carrick Brain Center, travel and lodging costs will be paid as a result of your participation in this study. There will not be any direct financial benefit beyond the cost of treatment. The additional risks to your health for participating in this study is minimal and should present no more risk or discomfort than a routine psychological or physical examination. At no time will your personal information be shared with any outside entity.

The requirements of this study will be presented to you in greater detail upon your arrival and you will be given the opportunity to ask questions of both the research and clinical staffs before any treatment or data is gathered.

By entering your name in the electronic signature below, you allow the answers you supply here to be used in determining your eligibility in this study as well as giving permission for the collected data to be used in this study.

I agree to the above statement.