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This is a pre-screening for the research study. Your participation is voluntary.

* 1. This online pre-screen survey is for the “polyphenol fruit” study at Clinical Nutrition Research Center, Illinois Institute of Technology.

If you are interested in this study, please complete the pre-screen survey questions in order to find out if you meet the pre-criteria before coming for on-site screening visit. There are no right or wrong answers. We appreciate your time.

The purpose of this study is to see how your body responds to a beverage with fruit polyphenols compared to a beverage without fruit polyphenols.
The procedures in this pre-screen survey do not involve any known risks. Participation is voluntary; at any time you may discontinue this survey.
You will not be compensated for either this pre-screen survey or screening visit, but will be compensated if you are eligible for and complete the clinical study visits.

Confidentiality will be maintained to the degree permitted by the technology used.
Your participation in this online survey involves risks similar to a person’s everyday use of the Internet.
Any information that we learn about you that can be traced to you will be used responsibly and will be protected against release to unauthorized persons.

If you met the pre-eligible criteria based on this survey, we will contact you for on-site screening visit. For the onsite screening, you will be asked to be fasting for at least 10 hours. During this time, we will ask that you do not eat or drink anything but water. We also ask that you drink water before arriving at our research center for your screening visit. It is important that you are fasting because we will be measuring your blood cholesterol and sugar levels at your on-site screening visit.

If you have any questions, please contact us at freemanstudies@iit.edu or 312-567-5300. In addition, you may contact the Institutional Review Board (IRB), which is concerned with protecting volunteers in research projects. You may reach the IRB office by contacting Glenn Krell MPA, CRA, Executive Officer, IIT IRB, e-mail: irb@iit.edu

By completing this survey, you are indicating your agreement to be screened for study participation. Your decision to complete the survey is voluntary. You can stop participation at any time without penalty.

I understand that Illinois Institute of Technology (IIT) is not responsible for any injuries or medical conditions I may suffer during the time I am a research subject unless those injuries or medical conditions are due to IIT's negligence.

I have read and fully understand it. I agree to take part in this pre-screen survey

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