Welcome to Our Qualifying Questionnaire

We are a branch of a larger market research company, whose goal is to make contact with as many people diagnosed or involved in the treatment of Lupus. We will be looking to reach out to those interested in the form of online surveys and telephone discussions to help understand the needs of Lupus patients and caregivers. When contacted and qualified we will pay respondents for their time (up to $100).

This project is solely concerned with marketing research and there will be no attempts to sell you anything or influence your pharmaceutical or treatment options in any way.

All information collected during the surveys or phone discussions will be completely confidential in that we will not show your name or any other identifying information to our clients.

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* 1. Are you the diagnosed patient or caregiver of diagnosed patient?

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* 2. When Diagnosed?

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* 3. Note Treatment use ever/currently

  Ever Current
NSAIDs (Advil, Motrin, others) and naproxen (Aleve)
Steroids, Corticosteroid medication, such as prednisone
Antimalarial drugs (hydroxychloroquine (Plaquenil))
belimumab (Benlysta)
Immunosuppressants (Imuran, Gengraf, etc)

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* 4. Please provide contact information as noted. Name and phone # not required at this time.

Thank you very much for taking the time to fill out this short questionnaire. We are collecting basic information to match individuals with specific survey requirements in order to invite your participation.