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Eligibility Screener
Please answer the following questions to see if you may qualify for the study:
Name
*
First
Last
Email
*
Phone Number
*
-
-
Zip/Postal Code
*
Are you 30 years of age or older?
*
Yes
No
Do you have type 1 diabetes?
*
Yes
No
Do you have type 2 diabetes?
*
Yes
No
Unsure
Have you suffered from a heart attack or chest pain that required hospitilization within the past 6 months?
*
Yes
No
Do you use Byetta® , Januvia®, or other incretin-based agents?
*
Yes
No
Unsure
Submit