Bipolar Self-Assessment Questionnaire
We are currently recruiting patients from 18 to 65 who are experiencing symptoms of bipolar disorder to participate in a research study evaluating an investigation medication.
Although you will need a full screening by our medical staff to be accepted into this study, your answers to this questionnaire are important. Please take a moment to answer the following questions and tell us about yourself.
How did you hear about Capital Clinical Research Associates?
Tell Us About Your Symptoms
Please let us know which of the following symptoms you may be experiencing. Please check all that apply.
Your Contact Information
Please tell us how to get in touch with you:
