ECHO is a nationwide research program whose mission is to enhance the health of children for generations to come. The goal is to learn how the environment affects children’s health and development, and how it acts together with genetic information.

To verify if you may be eligible to participate in the ECHO Research Study, we are asking you to complete this online eligibility screen.

Participation in this online eligibility screen will take about 5 minutes. In this eligibility screen, we will ask you for your first and last name, phone number, e-mail address, date of birth, city, state, and zip code, as well as your race and ethnicity.

All responses are treated as confidential. Be aware that confidentiality will be maintained to the extent possible. There is always the risk of compromising privacy, confidentiality and/or anonymity when using the internet. There is the possible risk of feeling uncomfortable about answering a question. You do not need to answer any question that you do not want to answer. This study is supported by NIH, and study information may be reviewed by NIH representatives and WCG IRB. Authorized representatives from the University of Pittsburgh Office of Research Protections may review your data solely for the purpose of monitoring the conduct of this study.

There is no direct benefit to you or your baby. Your alternative is to not take part.

Participation is voluntary. Refusal to fill out the eligibility screen will have no effect on your current or future relationship with the University of Pittsburgh, or your current or future medical care at a UPMC hospital or affiliated health care provider, or your current or future relationship with a health care insurance provider.

If you have any questions about your participation in this research study please contact the Research Coordinator, Maddie Block at 412-648-0252. An Institutional Review Board (IRB) oversees this research. An IRB is a group of people who perform independent review of research studies to protect the rights and welfare of participants. You may contact an IRB staff member by phone at (855) 818-2289, or by e-mail at clientcare@wcgclinical.com if you have questions, concerns, or complaints, or any questions about your rights.

You may print a copy of this form. If you understand the statements above, and freely consent to participate in the eligibility screen for the ECHO Research Study click on the “I Agree” button to begin the assessment.