Up to $850 + New Smart Watch Technology Study Survey

1.This study is a little bit different than what we normally do. It would involve you being scheduled for a bloodwork panel at a local LabCorp facility in the Los Angeles area, after which your results will be verified and should you qualify based on your results, you will be scheduled for an in-person enrollment session followed by up to a 3 to 6 month in-home participation, a clinical appointment including a heart image (CT image), and an in-person exit interview.

After you complete all study activities you would receive $850 and a new smart watch.

Blood Draw Visit	$100
Enrollment Visit	$100
Clinical Visit	$350
Study Completion Bonus	$100
Exit Visit / Device Return	$100
Travel Stipend	$100
Total	$850 + study watch

Should you qualify, are you still interested in participating in this research?(Required.)

Yes

No

2.Contact Info(Required.)

Full Name:

Email:

Phone:

Age:

Gender

City:

State:

3.What is your date of birth? (MM/DD/YYYY)(Required.)

DOB

Date

SuSunday

MoMonday

TuTuesday

WeWednesday

ThThursday

FrFriday

SaSaturday

4.What is your height?(Required.)

5.What is your weight (in lbs)?(Required.)

6.Please specify your race/ethnicity by indicating the most fitting description(s) below. This is to ensure there is a representative sample of participants enrolled in the research study. You may select multiple if more than one applies.(Required.)

East Asian (includes Chinese, Japanese, Korean)

South Asian (includes Asian Indian, Pakistani, Bangladeshi)

Southeast Asian (includes Cambodian, Filipino, Thai, Vietnamese)

Black, African American, or African (includes African American, Barbadian, Caribbean, Ethiopian, Ghanian, Haitian, Jamaican, Liberian, Nigerian, Somali, South African)

Hispanic, Latino, or Spanish (includes Colombian, Cuban, Dominican, Ecuadorian, Honduran, Mexican or Mexican American, Puerto Rican, Salvadoran, Spanish)

Middle Eastern or North African (includes Afghan, Algerian, Egyptian, Iranian, Iraqi, Israeli, Lebanese, Moroccan, Syrian, Tunisian)

Native Hawaiian or other Pacific Islander (includes Chamorro, Chuukese, Fijian, Marshallese, Native Hawaiian, Palauan, Samoan, Tahitian, Tongan)

American Indian or Alaska Native (includes Central or South American Indian)

White (includes Dutch, English, European not listed, French, German, Irish, Italian, Norwegian, Polish, Scottish)

7.What make and model of mobile phone do you currently use?(Required.)

8.Would you be willing to use a mobile phone with iOS operating system (iPhone) for up to 3 months during your study participation as your primary device?(Required.)

Yes

No

9.Would you be willing transfer the SIM from your current mobile phone to the study assigned iPhone for up to 3 months during your study participation?(Required.)

Yes

No

10.Does your current phone have a physical SIM or an electronic SIM (eSIM)?(Required.)

Physical SIM

eSim

Unsure

Up to $850 + New Smart Watch Technology Study

Thank you for your interest in this study!