Urea Cycle Disorders (UCD)

We are a branch of a larger market research company, whose goal is to make contact with as many people diagnosed or caregiver in the treatment of Urea Cycle Disorders (UCD). We will be looking to reach out to those who show interest in the form of online surveys and telephone discussions to understand the needs of UCD patients.

We will be conducting one-hour “telephone/internet” interviews with UCD patients/caregivers . For interview consideration, please complete “Qualifying Questionnaire”. Participants meeting survey parameters and completing interview will be paid for their time (up to $100). This project is purely concerned with research and there will be no attempts to sell you anything or influence your use of therapies in any way. Although the transcript of the online discussion will be recorded, all of your responses as well as your personal data will remain confidential.

Question Title

* 1. Please Indicate whether you are a UCD patient or caregiver

Patient

Caregiver

Other (please specify)

Question Title

* 2. Please indicate the specific UCD diagnosed.

CPS1

OTC

ASS1

ASL

ARG

NAGS

Unknown

Question Title

* 3. Please provide demographic information. Name, and phone # are requested not required.

Name:

ZIP: *

Country:

Email Address: *

Phone Number:

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 your participation.