Quality of Life Eligibility Questionnaire

  • Quality of Life Eligibility Questionnaire

    Answer the following questions to determine your eligibility for our clinical study
  • Do you currently have an ileostomy three (3) months or older?*
  • Are you willing to be evaluated to ensure your stoma and overall current health meet inclusion criteria?*
  • Are you willing to complete several quality-of-life questionnaires and daily diaries?*
  • Are you willing to use the device for the study period?*
  • Are you now, or are you willing to become in the future, a patients of Massachusetts General Brigham and Women's Hospital for the duration of the study?*
  • Are you willing to attend required study visits at the hospital (MGH Boston - Fruit Street) and complete quick telephone discussions during the study period?*
  • Should be Empty: