Before we move on to the screening questions, please read this statement regarding the privacy of the information you will be providing us in order to determine your eligibility in our study.

To determine if you are eligible to participate in the study, we would like to ask you some screening questions. This screening should take about 5 minutes to complete. The screening involves a few questions that may be sensitive in nature, including questions about weight and use of medications.  It is possible that some of these questions may upset you, in which case you can choose not to answer those. Some of these questions are required to determine eligibility; choosing not to answer them may result in your inability to participate in the study. There is also a risk of breach in confidentiality.  However, we take precautions to make sure, to the best of our ability, that confidentiality is not broken.  There are not any direct benefits. We expect that the information collected will help providers and patients in the future.

Any information about you obtained from or for this research study will be kept as confidential as possible.  Your name, address, and other personal identifying information will not be made known to anyone other than study personnel.  All records related to your involvement in this research study will be stored in a locked file cabinet.  In this study, you will be given a unique study identification number, which will be written on your study forms.

Your participation is voluntary, and you have the right to withdraw at any time. 

Click on the button to continue to the Screening:   Participate