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CREST-2 Stroke Prevention Study Eligibility Questionnaire

Have you or someone you know experienced narrowing of the carotid artery?

CREST-2 is seeking individuals who have narrowing in at least one carotid artery without stroke or stroke warning signs (TIAs or mini-strokes) caused by that artery for a research study. The information you provide will be kept confidential and used for study participation activity only. Interested participants will complete a questionnaire that will be sent to the CREST-2 Clinical Coordinating Center at Mayo Clinic. 
 
 
 
Please note that this website provides a questionnaire to help see if you may meet initial eligibility requirement for CREST-2. If you are found to be a potential candidate, you will be provided additional information on the CREST-2 stroke prevention study by a CREST-2 study team member.

1.What is your First Name?(Required.)
2.What is your Last Name?(Required.)
3.What is your Email Address?(Required.)
4.Confirm Email Address(Required.)
5.What is the best TELEPHONE NUMBER to reach you (during regular business hours)?
Please include area code: xxx-xxx-xxxx(Required.)
6.Do you have severe NARROWING of at least ONE CAROTID ARTERY?(Required.)
7.How SEVERE is the NARROWING?
8.Have you had a MAJOR STROKE CAUSED BY THAT ARTERY?
Thank you for your interest in CREST-2 and for taking time to complete this questionnaire. You will be contacted by a CREST-2 study team member with additional information regarding participation in the study.

For more information about the study visit www.crest2trial.org