Interested in participating in a depression study?

Fill out the form below to see if you qualify.

First Name*

Last Name*


Phone Number*

Have you felt down or depressed nearly every day for the past 2 weeks?
 yes no

When did this current episode begin or get worse?

​​Are you not able to enjoy the things you used to enjoy most of the time?
 yes no

- If yes, can you give an example?

How’s your appetite?

​Do you have trouble sleeping?
 yes no

Do you ever sleep longer than normal (10+ hours)?
 yes no

​Do you feel tired or without energy almost every day?
 yes no

​​Do you feel worthless or guilty almost every day?
 yes no

​Do you consider hurting yourself, feel suicidal, or wish you were dead?
 yes no

Have you had any suicide attempts in the past?
 yes no

- If yes, when did this occur?

​Have you ever had any periods of time where you felt so happy or hyper that you felt like you were on top of the world or could stay awake for several days?
 yes no

- If yes, how many days did this last?

How did you hear about us? (required)

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