IMSVISUAL Membership Application

Membership is free, voluntary and can be canceled at any time. Members can participate in IMSVISUAL activities and will be regularly updated on IMSVISUAL proceedings. We invite anyone with an interest in our goals to become a member but put a small formal hurdle on applications (see below) to ensure an active and evolving consortium.

Contact Information

First Name *

Last/Surname Name *

Organization *

Department *

Street Address *

Address Line 2

City *

State/Province/Region *

Zip/Postal Code *

Phone Number *

Country *

Email Address *

Position *

Who is the site PI at your institution for IMSVISUAL-related research purposes? *

Who is the point of contact for your site? *

Who is the point of contact to transfer data? *

Approximately how large is the clinical MS cohort at your center? *

Please list any additional affiliations you may have.