Adolescent Obesity

Is your child dealing with excess weight or obesity?

Would you like to learn more about a Clinical Research Study for an investigational medication for adolescents dealing with obesity? All study related medication and study‐related care will be provided.

Participants may be compensated up to $150 for each completed in person study visit if they qualify and participate.

No health insurance is required to participate. The study will involve up to 18 visits to a study site in your area.

What will I need to do?

Complete the on-line questionnaire. If the responses indicate your or your child may qualify, and you have provided the contact information for the parent/caregiver then a local clinical research site staff member will contact the parent/caregiver to provide the study details and to further assess if your child may be eligible. You will have the opportunity to ask questions about the APD356-A001-403 study.

Sign Up

Fields marked with an * are required.

If you are under the age of 13 (or 16 if you are in California or in Europe), you may not directly enter any information and your legal parent or guardian must enter this information on your behalf. By filling out this form, you are confirming that you meet these requirements.

Who are you interested in this study for? *

First Name of Potential Participant *

Last Name of Potential Study Participant *

What is the Potential Participant’s date of birth? *

ZIP or Postal Code of Potential Study Participant *

Have you (or your child, if parent or legal guardian is completing the form) been dealing with excess weight and obesity? *

How tall are you /your child in foot and inches (e.g. 5 foot 7 inches would be written as 5'7")? *

How much do you / your child weigh in Lbs (pounds)? *

Gender of Potential Participant *

Are you (or your child, if parent or legal guardian is completing the form) currently pregnant or breastfeeding or planning to become pregnant?

Have you (or your child, if parent or legal guardian is completing the form) been diagnosed, by a doctor, with Attention Deficit Disorder (ADHD)? *

Have you (or your child, if parent or legal guardian is completing the form) been diagnosed, by a doctor, with depression? *

In the past 6 months have you (or your child, if parent or legal guardian is completing the form) taken medications for a seizure disorder? *

Would you like to be contacted to learn more about the APD356-A001-403 study? *

Please note if you are under 18 years of age, your caregiver/parent may be contacted to discuss the study.

Name of caregiver/parent to contact *

Phone Number of caregiver/parent to contact *

Email of caregiver/parent to contact

Preferred contact method *

Best day of the week to contact you? *
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Best time of day to contact you? *
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The information you are providing here will be used to refer you to a clinical research study site in your local area participating in the APD356-A001-403 study. They will review your responses and may contact you to see if you’d like to learn more about the study and further assess your child’s eligibility by asking you additional questions. Please note the information you enter will be treated as confidential, except when ordered by law, and only accessible to our Clinical Research Partners, affiliates and applicable regulatory agencies. If you have any questions regarding the handling of the information you provide to us, or if you would like to make any changes, please contact us at info@autocruitment.com.