Chobani Hydration & Exercise Pre-screen

Hydration & Exercise Pre-Screener Questionnaire

This survey takes about 5 minutes and helps us see if you may qualify for a KGK Science study on hydration after exercise. You can skip any questions you’re not comfortable answering, but we need enough information to determine eligibility. By continuing, you agree to answer questions about your lifestyle and medical history and allow KGK Science to contact you about the study.
We would like to ensure the data we collect can be verified by researchers and send updates on the study should you qualify to participate. All information recorded will be maintained with the strictest confidentiality except as required by law. For more information, please review our Privacy Policy. https://kgkscience.com/privacy/
Full Name*

First NameLast Name
Email Address*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Please indicate your preferred contact method:*
Please indicate the best time of day to reach you.
Are you available to visit KGK Science for 4 weekly 10-hour visits over a 1 month period plus a 90 minute screening visit?*
Please Enter Your Date of Birth

MonthDayYear
Date
What was you assigned sex at birth?*
Are you presently pregnant, planning to become pregnant or presently breastfeeding?
Please enter your height
Inches
Please enter your weight
Pounds (lbs)
Have you experienced the following: (Please tick all that apply)

Difficulties with blood testsTrouble finding veinsUncomfortable with a cather being place in your arm for blood drawNone of the above
How often do you exercise per week?
What types of workouts do you do? Please select all that apply.

Pilates/YogaWalking/Treadmill WalkingTreadmill (Running)Biking/Spin ClassesOutdoor RunningBoxing/Cardio BoxingOther
On average, how many standard drinks do you consume per week?
Do you use tobacco/nicotine products?
Do you use cannabis

NoPrescription CannabisRecreational Cannabis
How often do you use recreational cannabis?
Please list any food allergies/sensitities you have.
Do you have a history of or currently have any of the following medical conditions? (Please tick all that apply)

Diabetes (Type 1 or Type 2)Thyroid Related DisordersChronic Kidney or Liver DiseasesHigh CholesterolHigh Blood PressureGI (Gastrointestinal) Issues or Diseases (e.g. IBS, Crohn's, Ulcerative Colitis)Cardiovascular Disease or History of Cardiac EventsPsychiatric ConditionsMetabolic ConditionsChronic Inflammatory ConditionsImmune-Compromised/Autoimmune ConditionsHep B, Hep C or HIVBlood/Bleeding DisordersNeurological ConditionsNone of the above
Is your medical condition currently stable, that is, are you being followed by a physician and taking prescribed medication to control your condition?

YesNoUnsure
Do you take any of the following prescription medications? (Please select all that apply)

Diuretics (e.g., hydrochlorothiazide, furosemide, spironolactone)Stimulant Laxatives (e.g., Sennosides, Bisacodyl)SGLT2 medications (Sodium-glucose cotransporter-2) e.g., Canagliflozin, Dapagliflozin, EmpagliflozinNone of the above
How long have you been taking these medications
How did you hear about this study? Please select all that apply.

Meta (Facebook/Instagram)WebsiteGoogleSomeone Referred MeTikTokOther
Please list the name/email of the person who referred you so we can thank them.
Why did you decide to participate in this study?

Interest in the topic being studiedCompensation for my participationI have done clinical trials beforeOther
Please select the Day(s) of the week you would be available for a 4 x 9-hour appointment. Please select all that apply.

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Additional Comments or Concerns
We will contact you within 2-3 business days.

I consent (by submitting the form) to receiving communications from KGK Science Inc. and their third-party service providers via email, text and phone.
Should be Empty:

Hydration & Exercise Pre-Screener Questionnaire

We will contact you within 2-3 business days.