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Screening Form
Please complete the screening form below
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Date of Birth
What city do you live in?
What state do you live in?
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What category best describes you?
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Are you between 25 and 50 years old?
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Are you fluent in spoken and written English?
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Do you often have trouble falling asleep?
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On average, how many hours do you sleep per night?
Are you able to spend 4 nights/5 days in the lab for the study?
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No
Are you willing to refrain from drinking caffeine and smoking for the duration of the study?
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No
Do you have any dietary restrictions or special diets?
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No
Do you have diabetes?
Yes
No
Do you have thyroid issues?
Yes
No
Are you currently taking any medications for ADHD?
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No
You agree that BuildClinical may provide your personal information to the research site to help determine if you are eligible for this study. Please refer to BuildClinical's Terms of Service and Privacy Policy for more information.
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BCFS00656
