Screen Reader Mode Icon

Question Title

* 1. What is your first and last name?

Question Title

* 2. What is your phone number?

Question Title

* 3. What is your email address?

Question Title

* 4. What is your age?

Question Title

* 5. What is your race or ethnicity?

Question Title

* 6. Have you ever been diagnosed with heart failure or have a history of heart failure?

Question Title

* 7. Have you had an ejection fraction measured within the last 6 months?

Question Title

* 8. Do you have an implantable cardioverter defibrillator ( ICD ) within last 6 months?

Question Title

* 9. Do you have any of the following?

Question Title

* 10. Are you willing to travel to our facility in Carnegie, PA which will require you to sit for up to 2 hours wearing a device? You will be compensated $200.00 for your time and participation. At no point in time will you be at risk. Appointments are being scheduled for April 2021.

0 of 10 answered
 

T