Please answer the questions below to the best of your knowledge. Identifiable information will be collected at the end of the questionnaire.

If it looks like you might be eligible, we will ask you to come into the clinic, where we will discuss the study with you in more detail, and you can decide if you want to participate.

Some of the questions below will be personal or confidential. All questions are IRB approved. This questionnaire will take approximately 10 minutes.

If you have any questions, please contact us as or 503-494-4311.

Thank you!

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