Thank you for your interest in the BEAT-MS study. To see if you may qualify to participate, please answer the following questions. It should take no more than 5 minutes to complete this questionnaire. If you pass the pre-screening questions, you will have the opportunity to provide your contact information so that a member of the BEAT-MS team can contact you, ask more questions, and possibly refer you for a screening visit.

1.
Are you between the ages of 18 and 55?
2.
Have you taken any of the following medications for relapsing MS in the past 3 years? (check all that apply)
3.
In the past year, have you had an MS relapse (attack, exacerbation, worsening of MS symptoms that lasts for several days) or new MS findings on MRI, on or off medication?
4.
Have you had at least one MS relapse (attack, exacerbation, worsening of MS symptoms that lasts for several days) or new MS findings on MRI during the last 3 years while taking one of the medications in question 2?
5.
Are you able to walk 100 yards (the length of a football field)? It's ok if you need to rest or use a cane, one crutch, or one brace.
6.
How did you hear about us? (check all that apply)