We are recruiting PATIENTS/CAREGIVERS of individuals medically diagnosed with NASH (nonalcoholic steatohepatitis) for a marketing research project on behalf of BluePrint Research Group; a firm that works with healthcare companies to help these companies better understand the management and treatment of NASH.

Since we are looking for many different varieties of individuals to participate in this project, I would like to ask you some questions about your diagnosis. If you qualify for the study, you will be compensated (up to US $100.00) for your time in participating in a completed interview.

Please be assured that this interview is in no way intended to be promotional and no attempt will be made to sell you anything. Your name and identity will not be released and all your responses will be held in strictest confidence.

Should you be selected for the interview it will be recorded on audio for the purposes of developing a report to represent the opinion of all research participants. Any claims or data contained in any materials shown to you during the discussion should be regarded as hypothetical and some of the information from this study relates to unlicensed indications.

Your responses will be collated with those of other respondents and presented to the sponsor in an aggregate or confidential form. Representatives of the company commissioning the study may be listening to the research and, in accordance with standard confidentiality guidelines, your identity will remain strictly confidential. The company who is commissioning this research does not hold or see any information regarding respondents.

* 1. Are you the patient or caregiver?

* 2. Has “NASH” been diagnosed by a physician?

* 3. What is your (diagnosed patient) age?

* 4. What was your (diagnosed patient) age when orginialy diagnosed?

* 5. Was diagnoses confirmed with biopsy?


* 6. If biopsy preformed please note Month/Year

* 7. Indicate if your current treatment includes any/all of the following.

* 8. We are requesting limited demographic information, name, zip and phone are optional. Email is required in order to notify you of paid interview recruitment.

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 qualified individuals.
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