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Find a Clinical Trial
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Clinical Trials
Find a Clinical Trial
Check Your Eligibility
Join Our Clinical Trial Registry
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Areas of Focus
Liver Disease
Metabolic Health & Obesity
Cardiometabolic & Vascular Health
Immunology & Inflammation
Early Phase & Pharmacokinetic (PK) Studies
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Why Sponsors Partner With Evidentis
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About Evidentis
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Contact Us
(682) 651-1112
Find a Clinical Trial
|
Check Your Eligibility
|
Join Our Clinical Trial Registry
|
Sponsors & CROs
|
Contact Us
Home
Clinical Trials
Find a Clinical Trial
Check Your Eligibility
Join Our Clinical Trial Registry
How Clinical Trial Participation Works
Participant FAQs
Provider Referrals
Areas of Focus
Liver Disease
Metabolic Health & Obesity
Cardiometabolic & Vascular Health
Immunology & Inflammation
Early Phase & Pharmacokinetic (PK) Studies
Sponsors & CROs
Why Sponsors Partner With Evidentis
Capabilities & Infrastructure
Startup & Feasibility
Quality & Compliance
Request Feasibility
Consulting & Advisory Services
Strategic Partnerships
About Us
About Evidentis
Meet The Team
Research & Publications
Careers
Location & Hours
Contact Us
CRIO Webform
Sex:
Female
Male
Intersex
Race/Ethnicity:
White (Hispanic or Latino)
White (Not Hispanic or Latino)
Asian
Native Hawaiian or Other Pacific Islander
American Indian or Alaskan Native
Black or African American
Other
State:
AK
AL
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
IA
ID
IL
IN
KS
KY
LA
MA
MD
ME
MI
MN
MO
MS
MT
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ND
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NM
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OH
OK
OR
PA
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Argentina
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Canada
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France
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Honduras
Hungary
India
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New Zealand
Netherlands
Panama
Poland
Portugal
Puerto Rico
Romania
Rwanda
South Africa
Spain
Sweden
Switzerland
Turkey
Ukraine
United Kingdom
Medical History
Fatty liver disease (MASLD / MASH / NASH)
Alcohol-related liver disease
Hepatitis C
Hepatitis B
Cirrhosis or advanced liver disease
Other liver condition (not listed above)
Diabetes or prediabetes
High blood pressure
High cholesterol
Obesity or weight-related health concerns
Heart disease
Kidney disease
Cancer (past or current)
None of the above
Not sure
How often do you currently drink alcohol?
Never
Less than once a month
1 to 3 days per month
1 to 2 days per week
3 to 4 days per week
5 or more days per week
Prefer not to answer
On days when you drink, about how many drinks do you usually have?
1
2
3 to 4
5 to 6
7 or more
Not sure
Prefer not to answer
I agree to the following:
I agree to have my information stored in the Evidentis Clinical Research registry and to be contacted about current or future studies. I understand that I am not enrolling in a study by submitting this form.
