Participate in Our Email Lists

Join research studies and more with our email lists.

We’ll send you opportunities related to:

• Research studies and surveys
• Guest speaking and panels
• Interviews

This includes events from Cogentica, other groups, and other people.

Participation is voluntary. So you don’t have to join anything and should only try what you think is interesting.

Also, we don’t ask you to share your diagnoses in our email lists. Instead, choose what interests you. Disabled people, loved ones, experts, and anyone can pick anything.

At a minimum, please provide an email address and your city, state, and zip code. At this time, this form is in the development phase and may be expanded but your information will not be lost. Thanks, Cogentica

Sign up or edit your list(s) right here:

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Purpose of Registry

Though subject to change, the primary purpose of the disability registry is to have a listing of disabled individuals who we can contact to participate in surveys and marketing that are useful to the disability community. All solicited information is voluntary and you can skip any fields you are uncomfortable completing. Needless to say, all your responses are completely confidential and will not be released with any identifying information. At a minimum, please provide your email, sex, age, zipcode, and disability category.

Name *

First

Last

Email *

Address

Address Line 1

Address Line 2

City

— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Disability Category

• Hearing Difficulty - deaf or having serious difficulty hearing
• Vision Difficulty - blind or having serious difficulty seeing, even when wearing glasses
• Cognitive Difficulty - Because of a physical, mental, or emotional problem, having difficulty remembering, concentrating, or making decisions
• Ambulatory Difficulty - Having serious difficulty walking or climbing stairs
• Self-Care Difficulty - Having difficulty bathing or dressing
• Independent Living Difficulty - Because of a physical, mental, or emotional problem, having difficulty doing errands alone such as visiting a doctor’s office or shopping

The disability categories are useful should we seek to select individuals for participation in surveys or marketing studies. Please select all categories that are relevant.

Submit

If a list no longer interests you, then feel free to unsubscribe. After all, we don’t want to crowd your email with things you don’t like.

To learn more about how we protect your privacy, read our privacy policy.