Health Questions

The following are the questions participants are asked to respond to in order to complete their health profile:

Profile Usage

I am interested in being notified about clinical trials that fit my health profile.
I hereby give permission for my anonymized data to be used in scientific health research.

Age and Gender

What year were you born?
What is your gender identity?

Body Measurements

What is your height?
What is your weight?

Smoking

How many cigarettes or other nicotine products do you smoke per day on average?

Alcohol

How many standard servings of alcohol do you consume per week on average?

Metal Implants

Do you have any metal implanted in your body that would prohibit you from having an MRI?

Illnesses, Conditions, Diseases

Please enter all conditions you currently suffer from.
Please enter all conditions you have experienced in the past but are now clear of.
Please provide any important details about your major illnesses.
I am only interested in trials about.

Handedness

Which is your dominant hand?

Mental Health

Do you often have suicidal thoughts?

COVID-19

Have you ever tested positive for COVID-19?
Do you have Long COVID?

Ethnicity

What is your ethnicity?

Veteran

Are you a Veteran?

Prescription Drugs

Please enter all prescription drugs you regularly take.

Recreational Drugs

Which of the following drugs do you use?

Occupation

What is your current occupation? Check all that apply.

Immunizations

Which of these diseases have you been vaccinated against?

Surgeries

What types of surgeries have you undergone?

Medical Procedures

How many times have you had the following medical procedures.

Implanted Medical Devices

Which of the following medical devices do you currently have implanted?

Pregnancy

I am pregnant and my expected due date is.

Travel

If interested in participating in a clinical trial, how far would you be willing to travel?

Language

Which languages are you fluent in?

Education

What is the highest level of education you have achieved?

Diet

Which diets describe your eating habits?

OTC Medications & Supplements

List over-the counter medications and supplements that you take.

Allergies

What allergies do you have?

Stress Factors

Describe psychological and stress factors in your daily life.

Pain

Describe any chronic pain you experience.

Disabilities

Describe any physical disabilities you have.

Social Support

What social support networks do you have?

Sight

Eye conditions.

Hearing

Hearing impairments.

Teeth

Dental health.

Sleep

Sleep duration and quality.

Reproduction

Which contraceptive methods do you and your partner use?
Pregnancy history.
Menstrual history.
Menstrual Status.

Physical Activity

Physical activities you participate in (type and frequency).

Travel History

Recent travel history (especially to high health risk areas).

Work Hazards

Occupational hazards.

Environmental Factors

Factors affecting your health.

Heath Tracking Device

Which health tracking devices (smartwatches, bands, etc) do you use?

Family Medical History

Medical conditions that affect family members.

Submit Test Results

Recent lab results.
Recent imaging reports.
DNA Screening Results.

Please add your photo here.
This is optional. CenTrial will not share it or any of your info with the public. Your photo will only go, along with your health profile, to clinical trials that you will have expressed an interest in.