Disease-modifying treatments in Alzheimer's disease

Welcome to the BIDMC DiAD clinic!

To refer a patient to our clinic for consideration of disease-modifying treatments, please fill out patient information below.

We will be offering novel treatments following the FDA and our pharmacy's appropirate use criteria, which include but are not limited to:

A diagnosis of MCI or mild dementia due to Alzhiemer's disease, corresponding to an approx MMSE > 20

We are not able to offer treatment at this time for patients with:

Last Name

First Name

Date of Birth

BIDMC Medical Record #

Is this patient followed in BIDMC's CNU?

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Date of Initial CNU Eval for Cognitive Decline

Cognitive Neurology Unit Clinician

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Is the patient followed by another neurologist?

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Other clinician name and location

Patient Diagnosis and Stage

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Other Diagnosis

Referral Notes

Cognitive Testing if done:

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MMSE score

MOCA score

Mini-Cog score

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AD8 Score

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FAST score

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Is the patient on anticoagulation or DAPT?

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Patient Phone #

Who is the best point of contact for scheduling?

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Patient Email

Family or HCP name

Family or HCP email

Family or HCP Phone #

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