Research Participant Intake Form
Please fill out this form if you are interested in participating in the Sit-to-Stand + Wingate bike test. You will be contacted to discuss the details of this study and determine your eligibility for this study. Any further questions may be directed to: twhited@georgefox.edu. Thank you!
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Name (First, Last)
Date of Birth (DOB)
MM
/
DD
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YYYY
Gender
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Email
Phone Number
What is your preferred method of contact?
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When do you prefer to be contacted? Please state morning, afternoon, and/or evening. You may also add in a preferred time frame.
Have you been diagnosed with any of the following conditions? (You may include any other conditions you would like us to know about on the "Other" option below)
Do any of these health conditions apply to you?
A part of this study involves multiple finger pricks to measure blood lactate and blood glucose levels. Are you willing to have your finger pricked as a part of this study?
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How did you hear about this study?
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