Alzheimer's Research Advocacy & Support Form
About this free form template

Join the Movement for Better Alzheimer's Care and Research

Alzheimer's disease affects millions of families worldwide, and your voice matters in advancing research, improving care standards, and supporting those affected. This Alzheimer's Research Advocacy & Support Form is designed for caregivers, family members, patients, and concerned community members who want to make a difference.

Why This Form Matters

Whether you're navigating the challenges of caring for a loved one with Alzheimer's, interested in participating in clinical trials, or have concerns about memory care facility standards, this form gives you a platform to be heard. Advocacy organizations, research institutions, and healthcare providers use forms like this to understand the real experiences of those affected and to drive meaningful change in policy, funding, and care quality.

Built for Compassionate Advocacy

This template captures crucial information about caregiver burden, clinical trial interest, and facility quality concerns—all while maintaining sensitivity to the emotional weight of these topics. The form includes:

  • Personal story and experience sharing to humanize the data
  • Caregiver burden assessment to identify support needs
  • Clinical trial interest tracking to connect willing participants with research opportunities
  • Memory care facility quality concerns to advocate for better standards
  • Volunteer and donation pathways to build a community of supporters

Streamline Your Advocacy Efforts with Paperform

With Paperform's intuitive form builder, advocacy organizations can quickly deploy professional, compassionate forms that match their brand and mission. The conditional logic allows you to customize follow-up questions based on respondent roles (caregiver, patient, family member, or healthcare professional), ensuring everyone has a relevant and respectful experience.

Need to automate your advocacy workflows? Connect this form to Stepper to automatically route submissions to the right team members, send personalized follow-up emails, update your CRM with supporter information, and trigger volunteer onboarding sequences—all without writing a single line of code.

Want supporters to sign commitment pledges? Use Papersign to turn form submissions into formal advocacy pledges or research participation agreements that can be electronically signed and stored securely.

Who This Template Is For

This form template is ideal for:

  • Nonprofit organizations focused on Alzheimer's research and support
  • Research institutions recruiting for clinical trials
  • Advocacy groups building grassroots movements for policy change
  • Patient advocacy organizations collecting real-world experiences
  • Healthcare providers seeking to understand community needs
  • Memory care facilities wanting to improve their services based on feedback

The form is designed to be empathetic, accessible, and actionable—turning personal stories into data that drives change while building a community of engaged supporters ready to advocate for better Alzheimer's care and research.

Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Bitmap.png
HIR.png
HKTB-logo.png
Kenyon.png
Rice_University_Horizontal_Blue.png
accor-3.png
adp-1.png
avallain-logo-svg-160-px.png
axa-768.png
danone-2.png
deloitte-1.png
logo_andorra_telecom_df137f1a8f.png
michelin-4.png
raywhite.png
suncorp-logo-358x104.png
unesco.png
Built for growing businesses, trusted by bigger ones.
Trusted by 500K+ business owners and creators, and hundreds of millions of respondents. Small and growing teams across marketing, eCommerce, education, and professional services run their forms on Paperform.

Our customers love us, with an average rating of 4.8 out of 5 from 380 reviews across Capterra, Trustpilot, and G2.