MS Research study

Who should complete the pre-qualifying questionnaire for this study?

Any adult age 18 to 65 with primary progressive multiple sclerosis (PPMS) or non-active secondary progressive multiple sclerosis (SPMS) who has taken prescribed injected treatment for this condition in the past six months.

What if I am helping a person fill out the pre-qualifying questionnaire?

These questions are directed to the person who will participate in the research study. “You” as used in the pre-qualifying questionnaire refers to the person who may participate in the study.

Is there an obligation to continue if I complete the pre-qualifying questionnaire?

No. You may take the pre-qualifying questionnaire just to see if you might pre-qualify. Participation in a research study is completely voluntary at every step in the process. Submitting your information to a study center does not mean you will be able to participate, and you will be able to stop at any time with no penalty or loss of your regular benefits.

Pre-Qualifying Questionnaire

To see if you may qualify for this research study, please complete this Pre-Qualifying Questionnaire.

By clicking to begin the pre-screening process, you allow us to proceed with the pre-screening questions and to begin recording your answers. By clicking you also agree to the terms of the Privacy Policy.

Your name and contact information will not be associated with your answers unless you provide this information after you complete the pre-qualifying questionnaire.

Are you 18 to 65 years of age?

Yes No

How did you hear about this research study

Please enter your home or work zip code. This zip code will be used to locate a study center near you. Please provide the zip code that would be most convenient for you.

Enter 5-digit zip code

Have you been diagnosed with primary progressive multiple sclerosis or non-active secondary progressive multiple sclerosis (non-active SPMS means no relapses in the past 2 years)?

Yes No Unsure

Have you taken a prescribed injected treatment for your PPMS or non-active SPMS in the past 6 months?

Yes No Unsure

Completion Status

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