We're conducting a study on behalf of a major-medical firm and we would like to ask you a few questions to find out if you’d be interested in participating. The major-medical firm has developed a new syringe which could be used by people to administer medications.

We are searching for adults and children/ adolescents accompanied by their parents/ legal guardians that are interested in participating in this research.

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* 1. Contact Info

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* 2. Are you a healthcare professional?
(Someone who has received professional medical training (e.g. nurses, doctors))

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* 3. What is your....

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* 4. Have you or a child you care for (under 18) or an adult that you care for (i.e. aging parent, etc.) ever been diagnosed with.. (SKIP IF THIS DOES NOT APPLY TO YOU)

  i have My child has Other Adult
Seasonal Allergies
Asthma
Migraines
COPD
Chronic Idiopathic Urticaria ( a type of hives)
Food Allergies
Nasal Polyps
Depression/Anxiety
ADD/ADHD
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