$100 REPATHA RESEARCH STUDY - FOR MEN & WOMEN WITH HIGH CHOLESTEROL
CURRENTLY WE NEED THOSE THAT USES THE ON BODY INFUSOR DEVICE

We are interested in talking with people about some specific medications they may be taking. If you qualify based on the screening criteria, you will be asked to participate in a half hour telephone interview. We need men and women that are living with high cholesterol and using Repatha.

Participants who complete the telephone interview will receive a $100 incentive as a token of our appreciation. fill out the questionnaire and submit it. We will call you for scheduling....Everyone will need to send a photo of the prescribed device with their name on it.

Elite Market Research Team Nationwide
www.elitemarketresearchteamnationwide.net
Regina Roberts, Project Manager 419-754-1194

Email address *
What is your first and last name? *
Your answer
What is your telephone number? *
Your answer
What is your age? *
Your answer
In what STATE do you live? *
What is your gender? *
4. Here are some conditions you may or may not have. Please tell me if you have the specific condition. *
Required
5. You mentioned that you have high cholesterol. Are you currently being treated for this condition with prescription medicatiion *
6. Please tell me if you, yourself, are CURRENTLY taking any of these medications. Check those that apply *
Required
7. How long have you been on Repatha? *
8. Do you actually give yourself the injection or does someone else? *
9. Which way are you currently using REPATHA? *
10. Did you ever use the autoinjector before you started using the on-body infusor device? *
11. For you to qualify for this study, I will need you to send me a picture of your device OR the prescription or of the package it came in with your name on it. Are you willing to do that? *
HERE we need you mailing address....Within two weeks of completing your interview, we will send you the $100 incentive as a token of our appreciation. *
Your answer
Between now and the time of your interview, if you have another injection, will you please jot down anything, good or bad, you may want to share about that experience? *
HOW DID YOU LEARN OF THIS RESEARCH STUDY ON HIGH CHOLESTEROL AND REPATHA ON BODY INJECTOR DEVICE? *
Your answer
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