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Welcome to MindMate Research!

Health research changes people’s lives every day. Researchers still need your help. Many studies end early because there are not enough volunteers. We want to advance research and help by matching you with research studies. More information about the eligibility criteria:

- Male or female
- 18-80 years of age
- If you qualify and complete the study you may be compensated up to $1,500 for time and travel

Your name and contact information will not be shared and your answers will remain confidential. We will not use your information for any purpose other than to screen you for potential participation in this research study.

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1. Have you been diagnosed with Crohn's Disease by a doctor?

Yes

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2. How long have you been diagnosed with Crohn's Disease?

More than 3 months

Less than 3 months

N/A

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3. Have you ever had any of the following procedures done as part of your diagnosis?

Endoscopy - a camera is inserted through the mouth and used to view the throat, stomach, and/ or small intestine

Colonoscopy – a camera is inserted through the rectum and used to view the entire colon

Sigmoidoscopy - a camera is inserted through the rectum and used to view the closest section of the colon

None of the above

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4. Are you aware of any biopsy taken during this/these procedure/s?

Yes

Unsure

N/A

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5. Have you previously had treatment or therapy for your Crohn's Disease which was not successful in treating your condition?

Yes

Other (please specify)

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6. Do you currently have any of the following complications with your Crohn’s Disease?

History of a bowel resection within the past 3 months

Colostomy - an operation to divert one end of the colon (part of the bowel) through an opening in the abdomen

Ileostomy - an operation where the small intestine is diverted through an opening in the abdomen.

An abscess in your bowel or intestines (an inflamed area with collection of pus)

Require the use of a feeding tube for all nutrition

IV (parenteral) nutrition

None of the above

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7. Do you currently have a stoma or ostomy?

Yes

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8. Have you been diagnosed with any of the following conditions?

Ulcerative Colitis

Inflammatory bowel disease-unclassified (IBD-U)

abdominal or perianal abscess

Short Bowel Syndrome

None of the above

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9. Have you ever taken any medications to treat or manage your Crohn’s disease?

Yes

N/A

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10. Have you ever taken any of the following aminosalicylate or steroid medications to treat your Crohn's Disease?

Prednisone

Methylprednisolone

Budesonide

Mesalamine

Sulfasalazine

Olsalazine

Balsalazide

Budesonide

Beclomethasone

None of the above

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11. Have you ever taken any of the following 'Biologic' medications to treat your Chron's Disease?

Remicade (Infliximab)

Humira (adalimumab)

Cimzia (certolizumab)

Entyvio (vedolizumab)

Tysabri (natalizumab)

Stelara (ustekinumab)

None of the above

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12. When was the last time you took ‘Biologic’ medication from question 8?

Ongoing

1 week ago

1 month ago

6 months ago

1 year or more ago

Unsure

I have never take any of these medications

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13. How would you describe your condition/symptoms currently?

In remission (no symptoms, or symptoms do not interfere with daily activities)

Mild symptoms, but tolerable

Moderate symptoms, but I am managing

Severe symptoms that make my life difficult

Unsure

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14. Over the past week, how many liquid or very soft bowel movements, or episodes of diarrhea per day did you have on average?

None

1 to 4

More than 4

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15. Do you have a history of any of the following health conditions? (Tick all that apply)

Short Gut or Bowel Syndrome

HIV or AIDS

Kidney disease requiring dialysis or transplant

Liver disease such as cirrhosis

Schizophrenia

Heart attack, stroke, TIA (“mini-stroke”) or angina (heart- related chest pain) requiring hospitalization in the past 6 months

Drug or alcohol abuse problems in the past year

Cancer, except skin cancer or cervical cancer

None of the above

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16. Have you had any form of bowel surgery within the last 6 months?

Yes

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17. Have you had a solid organ transplant?

Yes

Not sure

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18. If female, are you pregnant or planning to become pregnant within the next 6 months?

Yes

NA / Male

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19. How tall are you in feet and inches?

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20. How much do you weigh in pounds?

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21. What is your date of birth (please use the following format YYYY-MM-DD)?

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22. Are you currently enrolled in another clinical trial?

Yes

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1. Have you been diagnosed with Crohn's Disease by a doctor?

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2. How long have you been diagnosed with Crohn's Disease?

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3. Have you ever had any of the following procedures done as part of your diagnosis?

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4. Are you aware of any biopsy taken during this/these procedure/s?

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5. Have you previously had treatment or therapy for your Crohn's Disease which was not successful in treating your condition?

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6. Do you currently have any of the following complications with your Crohn’s Disease?

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7. Do you currently have a stoma or ostomy?

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8. Have you been diagnosed with any of the following conditions?

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9. Have you ever taken any medications to treat or manage your Crohn’s disease?

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10. Have you ever taken any of the following aminosalicylate or steroid medications to treat your Crohn's Disease?

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11. Have you ever taken any of the following 'Biologic' medications to treat your Chron's Disease?

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12. When was the last time you took ‘Biologic’ medication from question 8?

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13. How would you describe your condition/symptoms currently?

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14. Over the past week, how many liquid or very soft bowel movements, or episodes of diarrhea per day did you have on average?

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15. Do you have a history of any of the following health conditions? (Tick all that apply)

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16. Have you had any form of bowel surgery within the last 6 months?

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17. Have you had a solid organ transplant?

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18. If female, are you pregnant or planning to become pregnant within the next 6 months?

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19. How tall are you in feet and inches?

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20. How much do you weigh in pounds?

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21. What is your date of birth (please use the following format YYYY-MM-DD)?

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22. Are you currently enrolled in another clinical trial?

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23. What is your first name?

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24. What is your last name?

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25. What is your email?

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26. What is your phone number?

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27. What is your ZIP/Postal code?

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28. When would be a good time for a researcher to contact you (we know you are busy)?

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29. Anything else you would like to tell the research team?