Entering your information on the form below indicates that you:

* are the patient registering for the study

* understand the study, and

* are willing to participate

If you would like to review information about the study again, to be sure you are willing to participate, please return to: HERE

If you have already completed part of the survey, you may continue where you left off. All you need is the return code given to you previously. Use the survey link to open the survey and click Returning? above right to enter your return code and continue the survey.

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You have selected an option that triggers this survey to end right now.
To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.