We are currently conducting a study to understand and explore health and well-being. If you qualify, we would like to ask you to take part of an Online Bulletin Board. The overall commitment is ~2 hours over ten days. We ask that you log into a secure platform each weekday for two weeks for 10-20 minutes to complete the daily activity.

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* 1. Contact Info

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* 2. Over the course of the research we may talk about different medications you may or may not be taking.

Different patients sometimes respond in different ways to the same medicine, and some side effects may not be discovered until many people have used a medicine over a period of time. For this reason, we are now required to pass on to our client, who is a manufacturer of medicines, details of any side effects related to their own products that are mentioned during the course of market research. Although what you say will, of course, be treated in confidence, should you mention during the discussion a side effect when you, or someone you know, became ill after taking one of our client’s medicines, we will need to report this, so that they can learn more about the safety of their medicines

Do you understand and agree to continue?

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* 3. The sponsor may wish to request further information from you. This will have no impact on the anonymity associated with the study itself. Please indicate whether you consent to us disclosing your name, contact information, and adverse event details to the sponsor in such situations.

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* 4. Are you or any member of your immediate family currently employed by a pharmaceutical company, a government regulatory agency, or as a consultant to any pharmaceutical or market research agencies?

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