Vanderbilt University
Institute of Imaging Science

Volunteer Form

First Name:
Last Name:
Date of Birth: (MM/DD/YYYY)
Male     Female
Phone Number: ###-###-####
Secondary Phone Number:
Mailing Address:
In order to be in one of our studies, you must meet the following minimum criteria:
  • You are at least 18 years of age.
  • You do not have a pacemaker.
  • You do not have any non-surgical metals in your body.
  • You do not have any non-removable metal, implants, or piercings in your head.
  • You are not claustrophobic.
  • You do not have any major physical or psychological illness.
Additionally please read through and click the box indicating that you understand the following:
  • This is a pre-screening only and you will be asked to complete a full screening and an informed consent before participation in any research.
  • Any information transferred from this point will be secured and will be available only to key study personnel at the Vanderbilt University Institute of Imaging Science.
  • Your information will be kept confidential by all study personnel and will remain on a password-protected internal server.
By clicking here you agree to the above statements

After submitting your information you may be contacted by one or more members of the VUIIS team for specific information relating to their studies.

If you have any questions please contact a member of the VUIIS team at