Page 1 of 10

Take this 4 question survey to make sure STAT is right for you!

Filling Out for Others: If you are filling out this survey on behalf of someone else, such as a family member or friend, please provide accurate information about their conditions to determine their compatibility with STAT.

Have you been diagnosed with any of the following conditions: (check all that apply)

Have you been diagnosed with any of the following conditions: (check all that apply)