Integrative Physiology of Aging Lab: Online Screening Form

Thank you for your interest in our studies assessing physiological function with age! Before you come in to learn more about our studies, it would be helpful to see if you are likely to qualify to be in one of our studies. In order to do this, we would like to ask you some eligibility questions, which will include questions about: demographics, availability, physical activity, smoking/alcohol consumption, and medical history. It should take about 15-20 minutes to go through these questions. Once you begin, you cannot save your answers and go back. You will need to complete the survey in one sitting. Some of the questions may make you uncomfortable; you do not have to answer any question that you would not like to answer, but without answers to most of these questions, you will not be eligible to participate in the study. Your responses are confidential and will only be used for research purposes; however, as with any information shared over the internet, there is a low risk for a confidentiality breach. The research team has minimized this risk by this survey being administered over REDCap, a secure, HIPAA-compliant, password-protected site for research data collection that only select research team members have access to.

You will be asked to fast before you come in for your first study visit because the screening blood draw necessitates it. This means you cannot eat anything, or drink anything except for water for 3-12 hours (depending on the study you are participating in) before your appointment. When you fast, you may feel lightheaded, dizzy, and/or weak. You may also be asked to refrain from over-the-counter medications for 48 hours, alcohol/strenuous exercise/marijuana/tobacco (if applicable) for 24 hours prior to your first appointment.

Participation in this pre-screening survey is voluntary. Your contact information will be saved and stored and you will be contacted for any future studies that you may qualify for. If you do not want to be contacted for future studies, select "No" to the question asking if you would like to be contacted for other studies you may qualify for. If you change your mind in the future about being contacted for other studies or if you would like your information deleted from our database, please contact us at the phone number(s) or email listed below. If you agree to participate in this pre-screening survey, please continue filling out the survey below; if not, simply exit without entering any information.

Feel free to call us at (303) 735-6410 or (303) 492-2485 or email us at ipalab@colorado.edu with any questions you may have. We are also required to give you the number of University of Colorado - Boulder IRB, the Ethics Board that oversees our research: it is (303) 735-3702, in case you have any questions or concerns for them. After you complete the form, a member of our research team will review your responses and contact you regarding your participation within 10 business days. Thank you for your time and consideration of our research!

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