After completing this brief questionnaire more detailed information will be given to you before you decide whether or not to take part in the research, and you will have the opportunity to speak with and ask questions of a study nurse and Doctor.
We would like to collect some of your health history to see if you are eligible for this study. All information you provide in this questionnaire will be held in strict confidence. We will share this information only with the research centre conducting the study. You can stop this interview at anytime and request that your information be deleted from our records.
Would you like to continue? *This question is required.