About the Clinic

The Northwest Clinical Research Center has been conducting clinical trials for over 15 years.  We have been extensively involved in research leading to the development of medications for depression and schizophrenia such as Seroquel, Risperdal, Zyprexa, Prozac, Zoloft, Paxil, Wellbutrin, Effexor, Lexapro, and Abilify.  Over ten thousand patients have been evaluated for clinical trials at NWCRC.

Questionnaire

Please let us know which of the following symptoms you’ve noticed your child has experienced:

 Social withdrawal Intense Anxiety Loss of appetite Loss of hygiene Delusions Difficulties processing information Hearing/seeing things that aren’t there Feeling depressed/causing self-harm NONE

Has your child been treated with schizophrenia before?
 Yes No

Is your child currently receiving treatment for schizophrenia?
 Yes No

Does your child have a history of any of the following?

 Seizure Disorder Stroke Head Injury Brain Tumor Cancer NONE

What is your child's gender?
 Male Female

How old is your child?

Parent's Name (First and Last):

Child's Name (First and Last):

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Is the child a resident of Washington State?

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