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<p style="border:1px solid black;padding:2px;"> <span style="display:block;border:1px solid grey;padding:10px;font-size: 125%;"> I am going to ask you a few questions to determine whether you are eligible to be in the study. <span style="font-weight: normal; font-style:italic;"> [Interviewer: Ask all questions without stopping until you reach "Determine Eligibility before continuing!"] </span></span></p> <h3 style="text-align: center; color: #800000;">Identifying Information</h3> 1. Name: |
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Demographics<div style="width: 100%; background-color: #fffacd; padding: 5px; position: relative; top: -5px; left: -5px;">Demographics Information<br /> <div style="width:100%; color:#FFF; background-color:#F00; padding:5px; position:relative; top:-5px; left:-5px;">Confidential</div></div> |
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<div class="green">Full Name</div> |
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