Lived Experience Advisory Group (LEAG) Interest Form for Caregivers and People Living with Dementia

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Thank you for your interest in joining the Dementia Caregiving LEAG. Please fill out the form below to receive more information on the LEAG.

If you have any questions, please reach out to Chelsea Kline at crkline@alz.org or Elma Johnson at elmabj@umn.edu.

First and Last Name: *

Preferred Email Address: *

How did you hear about the Dementia Caregiving LEAG? *

Are you:

Individual living with MCI, Alzheimer's, or another form of dementia

A current or former caregiver

Other:

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Which cultural community/communities do you identify with?

Please briefly explain some aspects of your background that lead you to want to contribute to the Dementia Caregiving LEAG. *

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