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Thank you for your interest in participating in our study! 

Please answer the following questions as accurately and honestly as possible so that we can determine if you are eligible to participate.
There are no right or wrong answers and all information you provide will remain confidential.

At the start of the survey, you will be asked for your contact information so that we may contact you about the study.
 
If you prefer to answer these questions over the phone, please give us a call at 919-537-9352.

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