FLORA Pre-screening survey

1

Do you have pre-diabetes? (e.g. has your doctor told you that you have pre-diabetes)* This field is required.This means that you must NOT have been diagnosed with Type 2 Diabetes or be on metformin or insulin (this will need to be checked by our trial nurse).

Yes

No

2

What gender are you?* This field is required.

Female

Male

Non-binary

Prefer not to say

3

Are you post-menopausal?* This field is required.

Yes

No

4

Are you willing to attend 3 visits as part of this trial?* This field is required.You will receive £50 per visit (£150 in total).

Yes

No

5

Are you aged 18-70?* This field is required.This will be checked by our trial nurse.

Yes

No

6

Great, you're likely to be eligible for the FLORA trial! The next step is for you to provide some information about yourself so the study team can reach you. 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 study 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.

Yes

No

7

What is your name?* This field is required.

First Name

Last Name

8

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

9

What's your email address?* This field is required.

example@example.com

10

What is your phone number?* This field is required.

Please enter your phone number. We need this in case the study team need to contact you.

11

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

If you have any questions, please email flora@lindushealth.com
or call us on 0800 0584121