PSRS Training Application

The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit North American phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

csGIiEREJmIWXyaz8RGsKEFaUVWYTjvfILWJUvCzaA5tAQx8Hrp

Thank you for your interest in becoming a PSRS rater. This instrument is designed to support consistent and standardized assessment of REM Sleep Behavior Disorder. The PSRS evaluates seven domains Cognitive, Behavioral/Psychiatric, Motor axial/gait/bulbar, Motor appendicular, Autonomic, Sleep, and Sensory. Currently, eligibility to complete PSRS rater training is limited to licensed medical doctors, and the instrument is currently available in English only.

The Prodromal Synucleinopathy Rating Scale and training manual were developed through funding support from the National Institute of Health, the National Institute of Neurological Disorders and Stroke, and the National Institute on Aging (Grants U19-AG071754 & R34-AG056639).

Certification involves:

Submitting an online application to verify clinical credentials
Completing five case-based scoring exercises
Demonstrating acceptable scoring reliability

Application & Certification Timeline
Please allow up to one week for your application to be reviewed. Once your application has been approved, you will receive an email from info@naps-rbd.org containing instructions for accessing and completing the required rater training and certification materials.

Please plan for the training and scoring exercise to take approximately 1.5 - 2 hours to complete. Training must be completed independently, and all certification requirements must be met before certification can be granted.

After submission of all five scored cases, please allow up to 1-2 weeks for review and processing of your certification results. You will be notified once the certification review has been completed

First Name

* must provide value

Last Name

* must provide value

Middle Initial(s)

Email address

* must provide value

Degree(s)

* must provide value

PhD

MsC

MSCI

Other

Other (specify)

Medical specialty

* must provide value

Medical License number (if applicable)

Licensing State/Region or country if outside the United States

Medical School Attended (Degree-Granting Institution)

* must provide value

Current Employer/Institution

* must provide value

Institutional Address
- Street address
- City
- State (if applicable)
- Zip/postal code
- Country (if outside the United States)

* must provide value

Expand

Current Job Title

* must provide value

Clinical experience with REM Sleep Behavior Disorder (brief description)

* must provide value

Expand

What is your primary reason for pursuing rater certification/training?

* must provide value

Investigator-initiated research study

Industry-sponsored research study

Clinical practice/patient care

Other (please specify)

reset

Name of research study

* must provide value

Please describe other reason for pursuing rater certification/training.

* must provide value

Please upload your cv or resume

* must provide value

Upload file

Please review each statement below and check the box next to each statement to indicate your agreement. All acknowledgments are required before proceeding.

* must provide value

I certify that the information provided is accurate and complete

I am currently practicing or qualified to assess patients with REM Sleep Behavior Disorder

I agree to complete the training and scoring exercise independently

I agree not to share the PSRS, associated materials, and the training module with any other person or organization/company/insititution

I understand that certification is contingent upon satisfactory scoring performance

Signature

* must provide value

Add signature

Date

* must provide value

M-D-Y

You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.