Participant Information

Please complete all the questions as accurately as possible.
We will only use your contact details to inform you, if you are eligible for this research project.
Your contact details and personal health information will remain strictly confidential. We will not give your details to anyone under any circumstances.

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* 1. Your contact details:

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* 2. Year of Birth

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* 3. Have you ever been diagnosed with any of these conditions?

  Yes No Not sure
Heart condition (including heart failure, or heart attack)
Hypertension (high blood pressure)
Stroke
Traumatic brain injury
Carotid Stenosis
Photosensitive Epilepsy 

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* 4. Please list any medications or supplements that you are prescribed or take regularly:

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* 5. Please tell us about your health habits and risk factors.

  Yes No Not sure
Do you smoke cigarettes, or have you in the past?
Do you consider yourself to be physically active?
Do you eat a healthy diet?

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* 6. Which gender are you?

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* 7.  Is this different from the sex you were assigned at birth?

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* 8. Females only: are you currently pre or postmenopausal?

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* 9. Females only: are you currently undergoing hormone replacement therapy or taking any other hormone supplements (estradiol, contraceptive pill etc.) ?

0 of 9 answered
 

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