ME&MGopen Survey

1

utm_source(Hidden field, for attribution of leads to Lindus, Unite Genomics etc.)

2

Are you aged 18 years or over?* This field is required.

YESNO

3

Have you been diagnosed with Myasthenia Gravis, including a positive serologic test for anti-AChR autoantibody?* This field is required.

YESNO

4

Can you provide a proof of diagnosis of generalized MG and AchR+ seropositivity and accept that it will be verified by a clinician?* This field is required.This could be a letter from a doctor confirming your diagnosis or a copy of your test result from your medical record (positive serologic test for anti-AChR autoantibody).

YESNO

5

Which country are you a resident of?

USA

Canada

Germany

6

Citrus site idNot shown to users - sets the site id correctly based on the country selected above

7

Thank you for your interest in this! We are not currently recruiting in Germany. However, we would like to collect your email so we can contact you as soon as recruitment starts.

example@example.com

Confirm Email

8

What operating system does your smartphone have?* This field is required.

iOS (Apple)

Android

Other/I don't have a smartphone

9

Great, you're likely to be eligible for this study! Do you consent to the information entered here being stored by Lindus Health, subject to the terms of our privacy policy, and being shared with the research team?* This field is required.Your consent is necessary in order to proceed. We will never share your data without your explicit consent. We may contact you about relevant future research opportunities, and you can opt-out of this at any time.

YESNO

10

What is your name?* This field is required.In the following questions we will just ask for your name, email, and phone number so that the research team can contact you.

First Name

Last Name

11

What is your preferred name?* This field is required.

12

What's your email address?* This field is required.In the following questions we will just ask for your name, email, and phone number so that the research team can contact you.

example@example.com

Confirm Email

13

What is your phone number?* This field is required.Your mobile number will only be shared with the research team to contact you about this study.

14

We are interested in new medications to treat MG and are hoping to recruit a number of patients to this study who are taking a novel therapeutic. Please answer the following question based on the medications you are currently taking for MG. Are you currently prescribed a C5 inhibitor therapy medicine for your Myasthenia Gravis?This would include one of the following examples: The IV medication Soliris (eculizumab), the iV or injectable medication Ultomiris (ravulizuman)

IV medication Soliris (eculizumab)

the IV or injectable medication Ultomiris (ravulizumab)

I am not taking a C5 inhibitor therapy medication

15

Thank you. Please click "SUBMIT" and you will be redirected to our Calendly tool, which you can use to book an appointment with the trial team at a time that is convenient for you.

If you have any questions, please email meandmgopen@lindushealth.com