Research Participation Form
Receive sample products to test, learn more about your health. Targeted to US Residents Only.
This is a prospective, single-arm, open-label study that will assess the efficacy of a one-month supplementation with a single sachet of Jigsaw MagSoothe in adults with consistently poor sleep quality, as measured by Oura ring sleep parameters over the prior month. Participants that meet the eligibility criteria for this study will receive a free Jigsaw's MagSoothe product, along with a $50 gift card for your participation.
Are you interested in improving your sleep quality?
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Yes
No
Have you been using Oura for at least 2 months?
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Yes
No
Using the Oura App, over the past 4 weeks do you meet any combination of the following conditions? [ Check all that apply ]
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Average sleep score of LESS than 75
Average readiness score of LESS than 75
Average sleep efficiency LESS than 75
Average deep sleep LESS than 45 minutes
Average REM sleep LESS than 45 minutes
None of these apply to me
How would you rate your sleep quality over the past three months?
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Very poor
Poor
Average
Good
Very good
Are you currently taking a magnesium supplement?
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Yes
No
Are you currently taking a prescription sleep medication?
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Yes
No
Have you received a medical diagnosis of sleep apnea?
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Yes
No
Are you pregnant or do you intend to become pregnant over the next three months?
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Yes
No
Are you undergoing chemotherapy or another form of treatment for cancer?
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Yes
No
What is your date of birth?
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-
Month
-
Day
Year
Date
What was your sex at birth?
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Male
Female
By checking the box below, I accept and authorize the collection, disclosure, and processing of my information as described in the Authorization Terms.
Your Signature
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Your Name
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First Name
Last Name
Address (we need this to ship you product)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Continue
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