In order to collect information for pre-screening, we have to get your permission to use and give out your or your child's personal health information. We will use a confidential REDCap survey to conduct the screening.

Your permission to use your or your child's health information for this study will not expire unless you tell us you want to cancel it. If you pass or your child passes pre- screening and you or you and your child consent to participating in the study, we will keep the information we collect for six years past the end of the study date. If you do or your child does not meet study requirements, or if you or your child do not consent to participation, their information will be deleted from our records. If you or your child cancels their permission, they will be removed from the study.

Please complete the survey below.

Thank you!

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