Sweet N' Sour Online Questionnaire

Thank you for your interest in our trial. To register your interest, please fill out the questions below and submit. This information is kept confidential and will not be used for any other purpose except for assessing your eligibility for the study. Once submitted, we will be contacting you via email or phone to discuss your eligibility and possible participation in the study.

Please let us know when it is best to contact you

You can put your own time if the drop down menu is not useful

Which post code do you live in

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If you were born in an other country, please identify how many years/months you have lived in Australia for

This study requires you to fast overnight and come to our clinical research facility (North Tce, Adelaide) around 8am for a few hours on four separate occasions over approximately 1 month. We can only perform the research Monday to Friday. Please identify which mornings may suit you best.

Have you ever been diagnosed with any form of diabetes? If so, please explain what form and when

Has a doctor ever said that you have prediabetes? If so when?

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Please list any prescribed or over-the-counter medication that you are taking and the reason you are taking it.

Have you been taking any antibiotics or received any anti fungal treatment in the past 3 months? If so what and when?

Please list any allergies you suffer from and any treatment you have received for this.

Have you ever been diagnosed with phenylketonuria? If so when?

Please list all surgery you have received, when you received it and why

Do you suffer from any gastrointestinal symptoms such as stomach ache, bloating, constipation or diarrhea?

Do you have a history of any serious illness, now or in the past?

Have you ever experienced any form of heart disease? If so, please explain when and the symptoms or diagnosis

Have you ever attended a hospital emergency department, and for what reason?

Do you suffer from any of the following symptoms? Please tick

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Alcohol consuption

How many standard drinks would you have in one week?

Smoking

Do you smoke cigarettes or vape on a regular basis?

Do you partake in regular exercise? If so, what type of exercise and how many hours per week

Do you restrict yourself from any food or drink?

In this study we are unable to enroll anyone who is trying to become pregnant or is pregnant or lactating. Please indicate if there is a chance of you being pregnant or you are lactating.

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Have you participated in other research studies and if so when was the last time?

This study requires you to tolerate a naso gastric tube ( a small flexible silicone tube, which is inserted through your nose into your stomach) for up to one hour on two occasions. It is not painful, just a little uncomfortable for a short time. Are you willing to try this?

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Have you donated blood in the last 3 months and if so when was your last donation?

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If you do not qualify for this study, may we contact you for other studies in the future that you may be eligible for?

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