Pre-screening Questionnaire: See If You Pre-qualify?

Please take a moment to answer the following questions to see if you are eligible to participate in the E.mbrace Study. The information you provide here will remain private and will only be used to determine if you, or someone you know, might be eligible for this study.

1. Are you 60 years of age or older? *This question is required.

2. Have you had at least 1 urinary tract infection in the past 2 years? *This question is required.
Why are we asking this question?

To be eligible for this study you must have had a urinary tract infection in the past 2 years.

3. Does your doctor know about your urinary tract infection? *This question is required.
Why are we asking this question?
To be eligible for this study your urinary tract infection must be recorded in your medical history.

4. Do you feel comfortable, or have a caregiver who is comfortable, using an application on a smartphone? *This question is required.
Why are we asking this question?
To participate in the study, you will need to fill out electronic questionnaires and potentially an eDiary.

FOR POTENTIAL STUDY PARTICIPANTS

FOR HEALTHCARE PROFESSIONALS