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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 18pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>UNITED STATES</B></P>

<P STYLE="font: 18pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>SECURITIES AND EXCHANGE COMMISSION</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Washington, D.C.&nbsp;20549</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 18pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>FORM 8-K</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>CURRENT REPORT</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Pursuant to Section 13 or 15(d) of the Securities
Exchange Act of 1934</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">Date of Report&nbsp;(Date of Earliest Event
Reported):&nbsp;<B>&nbsp;February 29, 2012</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 18pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>CNS RESPONSE, INC.</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Exact name of Company as specified in its charter)</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
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    <TD STYLE="width: 34%; vertical-align: top; text-autospace: none; font-weight: bold; text-align: center">Delaware</TD>
    <TD STYLE="width: 2%; vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="width: 31%; vertical-align: top; text-autospace: none; font-weight: bold; text-align: center">0-26285</TD>
    <TD STYLE="width: 2%; vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="width: 31%; vertical-align: top; text-autospace: none; font-weight: bold; text-align: center">87-0419387</TD></TR>
<TR>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">(State or other</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">(Commission File No.)</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">(I.R.S. Employer</TD></TR>
<TR>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">&nbsp;jurisdiction of</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">Identification No.)</TD></TR>
<TR>
    <TD STYLE="vertical-align: top; text-autospace: none; text-align: center">incorporation)</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: bottom; text-autospace: none">&nbsp;</TD>
    <TD STYLE="vertical-align: top; text-autospace: none">&nbsp;</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>85 Enterprise, Suite 410</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Aliso Viejo, CA&nbsp;92656</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Address of principal executive offices)</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>(714) 545-3288</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Registrant&rsquo;s telephone number, including
area code)</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center"><B>Not Applicable</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">(Former name or former address, if changed since
last report)</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">Check the appropriate box below if the Form 8-K filing is intended
to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 5%; text-autospace: none; font-family: Wingdings">o</TD>
    <TD STYLE="width: 95%; text-autospace: none">Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 5%; text-autospace: none; font-family: Wingdings">o</TD>
    <TD STYLE="width: 95%; text-autospace: none">Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 5%; text-autospace: none; font-family: Wingdings">o</TD>
    <TD STYLE="width: 95%; text-autospace: none">Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 5%; text-autospace: none; font-family: Wingdings">o</TD>
    <TD STYLE="width: 95%; text-autospace: none">Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: right">&nbsp;</P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0"></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Item 2.03</B></TD>
    <TD STYLE="width: 90%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Creation of a Direct Financial Obligation or an Obligation under an Off-Balance Sheet Arrangement of a Registrant.</B></TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify; text-indent: 0.5in">On February 29, 2012, CNS
Response Inc. (the &ldquo;Company&rdquo;) issued an unsecured convertible promissory note (the &ldquo;Note&rdquo;) in the aggregate
principal amount of $90,000 and a warrant to purchase 900,000 shares of common stock to the Zanett Opportunity Fund, Ltd.&nbsp;a
Bermuda corporation for which McAdoo Capital, Inc. is the investment manager. Mr. Zachary McAdoo, who is a member of the Company&rsquo;s
Board of Directors, is the president and owner of McAdoo Capital, Inc.&nbsp;From
the issuance of this Note the Company received $90,000 in gross proceeds.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify; text-indent: 0.5in">The Note matures on
February 28, 2013 (subject to earlier conversion or prepayment), earns interest equal to 9% per year with interest payable
at maturity, is convertible into shares of common stock of the Company at a conversion price of $0.10, is not secured and
is subordinated in all respects to the Company&rsquo;s obligations under its senior secured and subordinated secured
notes issued between October 2010 and&nbsp;January 2012 and the related guaranties issued to certain investors by SAIL
Venture Partners, L.P.&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify; text-indent: 0.5in">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify; text-indent: 0.5in">The conversion price of
the Note is subject to adjustment upon (1) the subdivision or combination of, or stock dividends paid on, the common stock; (2)
the issuance of cash dividends and distributions on the common stock; (3) the distribution of other capital stock, indebtedness
or other non-cash assets; and (4) the completion of a financing at a price below the conversion price then in effect.&nbsp;&nbsp;At
the closing of a public offering by the Company of shares of its common stock and/or other securities with gross proceeds to the
Company of at least $10 million (the &ldquo;Qualified Offering&rdquo;), the Note will be either redeemed or converted (in whole
or in part) at a conversion price equal to the lesser of the public offering price or the conversion price then in effect, with
the choice between redemption and conversion being at the sole option of the holder. The Note can be declared due and payable upon
an event of default, defined in the Note to occur, among other things, if the Company fails to pay principal and interest when
due, in the case of voluntary or involuntary bankruptcy or if the Company fails to perform any covenant or agreement as required
by the Note or materially breaches any representation or warranty in the Note.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify; text-indent: 0.5in">The warrant related to
the Note expires five years from the date of issuance and is exercisable for shares of common stock of the Company at an exercise
price of $0.10. Exercise price and number of shares issuable upon exercise are subject to adjustment (1) upon the subdivision or
combination of, or stock dividends paid on, the common stock; (2) in case of any reclassification, capital reorganization or change
in capital stock and (3) upon the completion of a financing at a price below the exercise price then in effect (including the Qualified
Offering), except that subsequent to the Qualified Offering, the exercise price will not be adjusted for any further financings.&nbsp;&nbsp;The
warrant contains a cashless exercise provision.&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-indent: 0.5in">The foregoing description of the Note and associated
warrant does not purport to be complete and is qualified in its entirety by reference to the full text of the form of Note and
form of warrant, which are filed as Exhibits 4.1 and 4.2 hereto and are incorporated by reference herein.&nbsp;&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Item 3.02</B></TD>
    <TD STYLE="width: 90%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Unregistered Sales of Equity Securities.</B></TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-indent: 0.5in">The Note and associated warrant were issued
by the Company under the exemption from registration afforded by Section 4(2) of the Securities Act of 1933, as amended, and Regulation
D promulgated thereunder, as they were issued to an accredited investor, without a view to distribution, and were not issued through
any general solicitation or advertisement.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: justify">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="width: 100%; font: 10pt Times New Roman, Times, Serif; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Item 9.01</B></TD>
    <TD STYLE="width: 90%; padding-right: 0.8pt; text-autospace: none; font-weight: bold"><B>Financial Statements and Exhibits.</B></TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<TABLE CELLSPACING="0" CELLPADDING="0" STYLE="font: 10pt Times New Roman, Times, Serif; width: 100%; border-collapse: collapse">
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 10%; padding-right: 0.8pt; text-autospace: none">4.1</TD>
    <TD STYLE="width: 2%; padding-right: 0.8pt; text-autospace: none">&nbsp;</TD>
    <TD STYLE="width: 88%; padding-right: 0.8pt; text-autospace: none">Form of Unsecured Convertible Promissory Note</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="padding-right: 0.8pt; text-autospace: none">4.2</TD>
    <TD STYLE="padding-right: 0.8pt; text-autospace: none">&nbsp;</TD>
    <TD STYLE="padding-right: 0.8pt; text-autospace: none">Form of Warrant</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt/0.05pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt/0.05pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt/1.5pt Times New Roman, Times, Serif; margin: 8.5pt 0 0; text-align: center; background-color: black">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: right">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0"></P>

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<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin-top: 0; text-align: center; margin-bottom: 0"><B>SIGNATURES</B></P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-align: center">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-indent: 49.5pt">Pursuant to the Securities Exchange Act of
1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0; text-indent: 49.5pt">&nbsp;</P>

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<TR STYLE="vertical-align: top">
    <TD STYLE="text-autospace: none">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="text-autospace: none">CNS Response, Inc.</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="text-autospace: none">&nbsp;</TD>
    <TD COLSPAN="2" STYLE="text-autospace: none">&nbsp;</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="width: 50%; text-autospace: none">&nbsp;</TD>
    <TD STYLE="width: 3%; text-autospace: none">By:</TD>
    <TD STYLE="width: 35%; border-bottom: black 1pt solid; text-autospace: none">/s/ Paul Buck</TD>
    <TD STYLE="width: 12%; text-autospace: none">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="text-autospace: none">March 5, 2012</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD>
    <TD STYLE="text-autospace: none">Paul Buck</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD></TR>
<TR STYLE="vertical-align: top">
    <TD STYLE="text-autospace: none">&nbsp;</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD>
    <TD STYLE="text-autospace: none; font-style: italic">Chief Financial Officer</TD>
    <TD STYLE="text-autospace: none">&nbsp;</TD></TR>
</TABLE>
<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>

<P STYLE="font: 10pt Times New Roman, Times, Serif; margin: 0">&nbsp;</P>



<P STYLE="margin: 0"></P>

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{"company-data": {"conformed-name": "CNS RESPONSE, INC.", "cik": "0000822370", "assigned-sic": "8090", "irs-number": "870419387", "state-of-incorporation": "DE", "fiscal-year-end": "0930"}, "filing-values": {"form-type": "8-K", "act": "34", "file-number": "000-26285", "film-number": "12668458"}, "business-address": {"street1": "85 ENTERPRISE", "street2": "SUITE 410,", "city": "ALISO VIEJO", "state": "CA", "zip": "92656", "phone": "(714) 545 3288"}, "mail-address": {"street1": "85 ENTERPRISE", "street2": "SUITE 410,", "city": "ALISO VIEJO", "state": "CA", "zip": "92656"}, "former-company": [{"former-conformed-name": "STRATIVATION, INC.", "date-changed": "20051115"}, {"former-conformed-name": "SalesTactix, Inc.", "date-changed": "20040805"}, {"former-conformed-name": "AGE RESEARCH INC", "date-changed": "19990210"}]}
UNITED STATES
SECURITIES AND EXCHANGE COMMISSION
Washington, D.C. 20549
FORM 8-K
CURRENT REPORT
Pursuant to Section 13 or 15(d) of the Securities
Exchange Act of 1934
Date of Report (Date of Earliest Event
Reported):
February 29, 2012
CNS RESPONSE, INC.
(Exact name of Company as specified in its charter)
Delaware
0-26285
87-0419387
(State or other
(Commission File No.)
(I.R.S. Employer
jurisdiction of
Identification No.)
incorporation)
85 Enterprise, Suite 410
Aliso Viejo, CA 92656
(Address of principal executive offices)
(714) 545-3288
(Registrant's telephone number, including
area code)
Not Applicable
(Former name or former address, if changed since
last report)
Check the appropriate box below if the Form 8-K filing is intended
to simultaneously satisfy the filing obligation of the registrant under any of the following provisions:
o
Written communications pursuant to Rule 425 under the Securities Act (17 CFR 230.425)
o
Soliciting material pursuant to Rule 14a-12 under the Exchange Act (17 CFR 240.14a-12)
o
Pre-commencement communications pursuant to Rule 14d-2(b) under the Exchange Act (17 CFR 240.14d-2(b))
o
Pre-commencement communications pursuant to Rule 13e-4(c) under the Exchange Act (17 CFR 240.13e-4(c))
Item 2.03
Creation of a Direct Financial Obligation or an Obligation under an Off-Balance Sheet Arrangement of a Registrant.
On February 29, 2012, CNS
Response Inc. (the "Company") issued an unsecured convertible promissory note (the "Note") in the aggregate
principal amount of $90,000 and a warrant to purchase 900,000 shares of common stock to the Zanett Opportunity Fund, Ltd. a
Bermuda corporation for which McAdoo Capital, Inc. is the investment manager. Mr. Zachary McAdoo, who is a member of the Company's
Board of Directors, is the president and owner of McAdoo Capital, Inc. From
the issuance of this Note the Company received $90,000 in gross proceeds.
The Note matures on
February 28, 2013 (subject to earlier conversion or prepayment), earns interest equal to 9% per year with interest payable
at maturity, is convertible into shares of common stock of the Company at a conversion price of $0.10, is not secured and
is subordinated in all respects to the Company's obligations under its senior secured and subordinated secured
notes issued between October 2010 and January 2012 and the related guaranties issued to certain investors by SAIL
Venture Partners, L.P.
The conversion price of
the Note is subject to adjustment upon (1) the subdivision or combination of, or stock dividends paid on, the common stock; (2)
the issuance of cash dividends and distributions on the common stock; (3) the distribution of other capital stock, indebtedness
or other non-cash assets; and (4) the completion of a financing at a price below the conversion price then in effect.  At
the closing of a public offering by the Company of shares of its common stock and/or other securities with gross proceeds to the
Company of at least $10 million (the "Qualified Offering"), the Note will be either redeemed or converted (in whole
or in part) at a conversion price equal to the lesser of the public offering price or the conversion price then in effect, with
the choice between redemption and conversion being at the sole option of the holder. The Note can be declared due and payable upon
an event of default, defined in the Note to occur, among other things, if the Company fails to pay principal and interest when
due, in the case of voluntary or involuntary bankruptcy or if the Company fails to perform any covenant or agreement as required
by the Note or materially breaches any representation or warranty in the Note.
The warrant related to
the Note expires five years from the date of issuance and is exercisable for shares of common stock of the Company at an exercise
price of $0.10. Exercise price and number of shares issuable upon exercise are subject to adjustment (1) upon the subdivision or
combination of, or stock dividends paid on, the common stock; (2) in case of any reclassification, capital reorganization or change
in capital stock and (3) upon the completion of a financing at a price below the exercise price then in effect (including the Qualified
Offering), except that subsequent to the Qualified Offering, the exercise price will not be adjusted for any further financings.  The
warrant contains a cashless exercise provision.
The foregoing description of the Note and associated
warrant does not purport to be complete and is qualified in its entirety by reference to the full text of the form of Note and
form of warrant, which are filed as Exhibits 4.1 and 4.2 hereto and are incorporated by reference herein.
Item 3.02
Unregistered Sales of Equity Securities.
The Note and associated warrant were issued
by the Company under the exemption from registration afforded by Section 4(2) of the Securities Act of 1933, as amended, and Regulation
D promulgated thereunder, as they were issued to an accredited investor, without a view to distribution, and were not issued through
any general solicitation or advertisement.
Item 9.01
Financial Statements and Exhibits.
4.1
Form of Unsecured Convertible Promissory Note
4.2
Form of Warrant
SIGNATURES
Pursuant to the Securities Exchange Act of
1934, as amended, the registrant has duly caused this report to be signed on its behalf by the undersigned hereunto duly authorized.
CNS Response, Inc.
By:
/s/ Paul Buck
March 5, 2012
Paul Buck
Chief Financial Officer