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$100 Online Study
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1.
Contact Info
(Required.)
Name
Phone
E-Mail
Gender
Age
City
State
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2.
Have you been diagnosed by a doctor with any of the following diseases / conditions?
(Required.)
Diabetes Type 1
Diabetes Type 2
Hepatitis B
Hepatitis C
Fatty liver (NAFLD/NASH)
Alcoholic-Related Liver Disease (ARLD)
Scarring of liver (fibrosis or cirrhosis)
Liver cancer
Lupus
Other Cancer
Parkinsons
None of the above
Other (please specify)
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3.
What is your current:
(Required.)
Height
Weight