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Your Information

Your First Name

Your email

Your City

Your State

Do you want help finding a study?
Yes

Washout

How long of a medication washout would you consider if you were guaranteed to receive the study drug for at least part of the study?
<5 days6-10 days11-14 daysmore than 14 days

How long of a medication washout would you consider if you could potentially only receive placebo?
<5 days6-10 days11-14 daysmore than 14 days

Most studies require a 2-week washout. If there was a 25% chance of receiving placebo, would you participate?
YesNoNot sure

Proximity to Site

How far would you travel to the study site to participate in a clinical trial?
10 miles or less11-20 miles21-30 miles31-50 milesmore than 50 miles

How far would you be willing to travel to the study site if transportation was provided?
10 miles or less11-20 miles21-30 miles31-50 milesmore than 50 miles

Transportation/Other Complimentary Services

How important is complimentary transportation (to the study site, work, etc.) when participating in a trial that requires medication withdrawal?
Very importantmoderately importantminimally importantnot important at all

Would you consider traveling by plane (all travel prepaid) if needed to participate in a study?
YesNoDepends on distance or length of stay

If a childcare stipend was offered, would that increase your ability to participate in a study?
YesNoNot applicable to me

If childcare is needed, how much would you expect to receive per hour of care?
$10 per hour$20 per hour$30 per hour$40 per hourNot applicable to me

Stipends

How important is financial compensation when considering participating in a clinical trial?
Very importantmoderately importantminimally importantnot important at all

If the study includes inpatient visits, do you expect a much higher stipend?
YesNoMaybe

How much of a stipend would you expect for staying overnight EACH night?
$100-200 per night$200-300 per night$300-400 per night

Study design for inpatient vs outpatient

If a study included several overnight visits, would you be willing to stay at the site for consecutive days/nights, or would you want to be able to go home between those visits?
Willing to stayPrefer to go home between visitsDepends on the total number of consecutive daysDepends on the stipend amount

How many consecutive days would you be willing/able to stay at the study site?
1-2 days3-5 days6-10 daysmore than 10 day

If the study required ONE overnight, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required TWO consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required THREE consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required FOUR consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required FIVE consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required SIX consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required SEVEN consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

If the study required TWO WEEKS of consecutive overnights, what is the likelihood you would participate?
0-10%10-25%25-50%50-75%75-100%

General

What is most important to YOU when considering participating in a research study? Please be specific.

Is there anything else you would like to add? Please be specific.