We are a startup company, working closely with professors at Stanford, to develop a product that will help protect people from accidentally eating gluten. To do this, we need to better understand the circumstances in which accidental gluten consumption takes place. We are in the very early stages of product development, seeking to interview adults (or parents of children) with celiac disease or non-celiac gluten sensitivity. We will ask questions about how you were diagnosed, eating habits, and dining out to give us the feedback we need to make the product most useful. All information provided will be confidential and will not be shared with a third party.

The interviews are approximately 30-45 minutes long. They can either be done on the phone or in person (at your home or local coffee shop). You will not be asked to consume any foods. Each interviewee will receive $25 and be entered into a pool to win an iPad Mini.

If interested, please fill out the following form:

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* 1. Have you (or your child) been diagnosed with celiac disease?

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* 2. What happens when you (or your child) eats food with gluten?

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* 3. When was the last time you (or your child) accidentally consumed gluten and had a bad reaction?

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* 4. When you (or your child) eats gluten, how bad are the reactions (on a scale of 1-5)? 1 = minor, 5 = very bad.

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* 5. Would you rather be interviewed in person or over the phone?

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* 6. Please share your contact information

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