Neurogen Biomarking

Intro
Personal Details
Shipping Address
Health Questions
Demographics
Cognitive Test
Billing

Request A Kit
* indicate required fields

Let’s determine if the Neurogen Biomarking At-Home Test Kit is right for you.

Is this order for you or a loved one?

For caretakers requesting for a loved one:

Make sure your loved one is present. In order to properly gauge their risk for Alzheimer's, there is a short cognitive assessment that they must complete themselves.
You may assist with answering the questions and navigating the form to ensure that the responses accurately reflect your loved one's condition.

*I confirm that I have read and accept the Privacy Policy, Terms of Use and Consent Form

Please confirm you have read and accept the terms

Personal Information

Salutation*

First Name*

Last Name*

Primary Phone*

Secondary Phone

Email*

Date of Birth*

Sex at Birth*

Shipping Address

Shipping Address*

Country*

City*

State*

Zip*

How are you doing?

1. Do you have a family history of Alzheimer’s?*

2. Do you have Down syndrome?*

Do you feel like you are having difficulty with any of the following?

We'd like to know how you're doing, and whether you are having any difficulties in your everyday life.

Please answer these questions to the best of your ability. If you are not confident in your answer, please select "not sure”.

3. Remembering words or naming objects*

4. Short-term memory*

5. Attention, focus or concentration*

Demographics

Education*

Select the option that most closely reflects your level of education.

Race

Ethnicity

Cognitive Testing

Linus Health Cognitive Assessment

You are required to complete a cognitive assessment. For this assessment we partner with Linus Health, a next-generation digital cognitive assessment platform that enables earlier detection and intervention in brain health.

This assessment should take 1-3 minutes, and involves simple responses to a single prompt.
You will need a working microphone.
You will not receive results from this assessment until they are reviewed by the neurologist.

Please click the NEXT button

Billing

Click the Submit button. You will be directed to our payment portal. We will collect your payment information but you will NOT be charged until our medical team approves your kit.
Following the collection of your payment information, you will be directed to Linus Health for a short cognitive assessment which will help determine if the At-Home Test Kit is right for you.