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Research Study
on skin thickness |
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Lipid abnormalities |
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We need volunteers to help us with a study of skin thickness. We want to find if there is a change in skin thickness associated with certain types of diseases. This is a simple study which takes very little time and has no risk. You can participate from home or ask your doctor or nutritionist to help you.
To participate, you simply complete the following questionnaire and e-mail the results to us. There is no need to use your real name. However, if you would like us to thank you for participation, you should sign the statement below. Your name will be listed as a participant, but your data will not be identified with your name.
To complete these questions, you need a good scale, a tape measure, and an inexpensive gadget that measures your skin thickness. Most nutritionists or doctors or nurses will know how to help you get these measures. Next time you visit your doctor, ask for their help.
Optional Information:
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Please list my name, ___________________, as a participant in your study of Skin Thickness. I authorize you to release my name wherever you consider appropriate. My address and phone number will not be published. Signed Name Address Phone Notary public statement indicating that you are who you claim to be. |
Required information:
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Name (or create a unique name for yourself, like a password) Age Sex Weight without clothes (indicate pounds or kg) Indicate inches or centimeters:
Skin fold thickness:
% body fat (if possible, not critical) The following values fasting (12-14 hours):
Indicate any of the following diseases you have: q Cancer (any type) q Cardiovascular Disease q Coronary Artery Disease q Muscular disorder q Neurological disorer q High blood pressure q Diabetes Type I q Diabetes Type II q Immune disorder q Lung Disease q Inflammatory Bowel Disease q Other intestinal disease q Other gastric-mouth disease q Kidney disease q Liver disease q Other (explain) |
Thank you.
Send to: research@essentialfats.com
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By
reading this web site, you agree to read & comply with the following
instructions: You agree to pay us $300 for each unsolicited communication to sell us unsolicited products/services (by e-mail, mail, phone, etc.). Read details. |
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© 1998 Edward N.
Siguel. All rights reserved |
modified 1/15/00 |