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What is a Medical Research Study?
This website is for a medical research study to evaluate the safety and effectiveness of an investigational
medication for those with an open sore on their leg between their knee and ankle. There are several types of
leg sores, and this is a research study for a commonly occurring type called venous leg sores or venous leg
ulcers. Typically, these are chronic leg wounds that take a long time to heal.
To see if you may qualify for this medical research study,
please complete this Pre-Qualifying Questionnaire.
These questions are to be answered by the person who would be enrolled in the research study if they
qualify. You do not have to answer any questions you do not want to answer. You may stop this questionnaire at any time.
If you are visiting this website for someone else, please provide this website link to them so that
they may complete the questionnaire.
As used in these questions, "you" or "your" refers to the person who would be enrolled in the research study
if they qualify.
information, along with your answers to the questionnaire, to a study clinic conducting this research study.
Except as noted above, no personally-identifiable information will be taken from you and your answers will
remain confidential. We will not use your information for any purpose other than to screen you for potential
participation in this research study. Your answers will be stored with us for up to three years. However,
your answers will not be identified to you in any way unless you provide us with your information at the
conclusion of the questionnaire. If you provide your or a friend’s/family member’s email address, the
email address will not be provided to anyone other than the person to whom the email was sent as specified
in this website. The person in charge of privacy for this website is the Privacy Officer, who may be
contacted at 6207 Bee Cave Road, Suite 288, Austin, Texas 78746 or email@example.com to make any updates
to your information or to have your information removed.