Request a custom table Please note that before receiving a custom data table you will be asked to acknowledge the NACC Data Use Agreement. Please provide the information requested below, and then click the Continue button to submit the form. You will be contacted by a NACC staff member within two business days. NACC TABLE REQUEST FORM Contact information: First name: Last name: Title: Dr. Ms. Mr. Mrs. None Address: Home institution: City: State: Zip: Email address: Phone number: Are you affiliated with an ADC? Not affiliated with an ADC NIA NACC Arizona ADC Boston University Columbia University Emory University Florida Alziemers Center Indiana University Johns Hopkins University Massachusetts ADRC Mayo Clinic Mt. Sinai New York University Northwestern University Oregon Health & Science University Rush University Stanford University UC Davis UC Irvine UCLA UCSD UCSF University of Kansas University of Kentucky University of Pennsylvania University of Pittsburgh USC UTSW University of Washington University of Wisconsin Washington University in St. Louis Yale University Please provide details of the table you are requesting: How did you learn about NACC data? (Select all that apply) Researcher or clinician affiliated with an ADC Web search (specify web page found from) Conference Friend or colleague GAAIN (Global Alzheimer's Association Internactive Network) Other (specify): After entering the information above, please press the Continue button. You will be given a chance to verify or edit the information before submitting it to NACC. Once you submit the request, another option will allow you to upload a PDF or MS Word file with table formats or further information.