To see if you may qualify for this clinical research study, please complete this Pre-Qualifying Questionnaire.

Have you experienced financial or work problems, relationship problems such as divorce or conflict, health issues, emotional stress due to illness, or other stressful events?

	Yes
	No

How did you hear about this clinical research study?

Please enter your home or work zip code. This zip code will be used to locate a study center near you. Please provide the zip code that would be most convenient to you.

Enter 5-digit zip code

Please describe the type of stressful event that you experienced.

By clicking you authorize us to proceed with the pre-screening process and to begin recording your answers. By clicking you also consent to the terms of the Privacy and Confidentiality Policy. Your name and contact information will not be associated with your answers unless you provide this information after you complete the pre-qualifying questionnaire.

Welcome to our website for a clinical research study of an investigational drug for adults experiencing a condition known as "adjustment disorder with anxiety."

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