Client Management: ___________________
Dr. Richard Parenté
To activate or set up your new ADAMS Profile account, please fill out the relevant information below.
• You may add additional Family/Friend/Co-Worker Cognitive Complaint Surveys by clicking on the Add Another buttons.
• You may also send invitations one-at-a-time with the Print or Send buttons, or all-at-once with the SUBMIT button
at the bottom of the screen.
Client Name:
Date of Birth:
(First Name)
(MI)
(Last Name)
(Month)
(Day)
(Year)
(Enter Email Address)
[Unique I.D. No.]
Client Survey:
Invitation
Invitation
Questionnaire I.D.
Name:
Relationship:
(First Name)
(Last Name)
(Relationship)
(Enter Email Address)
[Unique I.D. No.]
Family Surveys:
Invitation
Invitation
Questionnaire I.D.
Add another family Survey:
Name:
Date of Birth:
(First Name)
(Last Name)
(Relationship)
(Enter Email Address)
[Unique I.D. No.]
Friend/Co-Worker Surveys:
Invitation
Invitation
Questionnaire I.D.
Add another friend or co-worker Survey:
Notes to Reviewers:
• Click here to take
Observer path.
© 2014 iLearn Systems, Inc.
Designed and Developed for PMI, the Practical Memory Institute®