The Matrix Group Central Kentucky Resident Study

Thank you for your interest in our research study! Please fill out the following questionnaire that will help us determine if you qualify to participate. If you meet the minimum eligibility requirements, you may be contacted by telephone by a Matrix Group representative to continue the eligibility process.

Instructions:
Please complete the questions by clicking on the appropriate button(s) or by typing applicable text responses in the space(s) provided.

Note: Pressing the "enter" key, or using the "back" button on your browser may cause your reponses to be lost. To go back to a previous page, please click the [<<Previous] button at the bottom of the screen.

Please click the [Submit] button at the end of the survey to submit your responses.

Click the [Next>>] button below to take the survey now.