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GYROSCOPE RESEARCH PROGRAM
ONLINE WEB PRE-SCREEN FORM

Thank you for your interest in research for age-related macular degeneration (AMD).

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Gyroscope Therapeutics is a clinical-stage gene therapy company focused on diseases of the eye. We are working with some of the world’s leading gene therapy and retina experts to evaluate whether our investigational gene therapy, GT005, can slow the progression of advanced dry AMD that can lead to blindness. We are also conducting broad observational studies to learn more about the impact of genetics on advanced dry AMD or geographic atrophy (GA). You can learn more about specific Gyroscope studies here.

If you or a loved one have been diagnosed with AMD and would like to learn more about participating in Gyroscope’s research program, please complete our brief screening questionnaire below.

The first section asks a few questions to obtain permission to collect, process and store your personal data in association with a Gyroscope Therapeutics clinical trial and for the purpose of evaluating whether you meet the initial eligibility criteria. If you are eligible, Gyroscope will forward your personal information collected in this conversation to the investigators for Gyroscope Therapeutics clinical trials so they can further assess the information collected to discuss potential participation in a Gyroscope Therapeutics clinical trial. Upon forwarding your information to the site, Gyroscope will delete your personal information.

For the purposes of this questionnaire, a clinical trial site is defined as a selected clinic participating in Gyroscope sponsored studies for GA. GA is a form of advanced dry AMD associated with loss of retina/tissue in back of eyes that may lead to vision loss.

Do you consent to Gyroscope Therapeutics using the personal data collected about you in this questionnaire as follows? Please note that you may withdraw your consent at any time, or choose not to answer any of the questions asked by us:

Having trouble reading this form? Call us to learn more about research in your area:
US: +1 (866) 948 7517