TDIS Request Form

The Tardive Dyskinesia Impact Scale (TDIS) is a clinically validated, disease-specific, patient-reported outcome measure designed to assess the impact of tardive dyskinesia on daily functioning.

To request the TDIS, please complete the form below. Our team will be notified, and you will receive a separate email from DocuSign containing a link to review and electronically sign the Licensure Agreement, which outlines the terms and conditions for use of the TDIS.  

As stated in the TDIS Licensure Agreement, the sole purpose for the TDIS is as follows: 

• Educational and academic use, including use as a training tool for students.  

The TDIS is not approved for use in clinical practice, research, or publications without the expressed written consent of Neurocrine Biosciences, Inc.

Once the agreement is signed, our team will co-sign on behalf of Neurocrine Biosciences, Inc. You will then receive a follow-up email with a copy of the TDIS.

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