See if you Qualify

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Pre-Screening Questions

How did you hear about us?  








What is your date of birth? (Parents or legal guardians of potential participants under 18 may answer and complete the questionnaire on behalf of the child).
Please select your gender:

Have you been diagnosed with ulcerative colitis (UC) by a doctor?


Has your doctor confirmed your diagnosis of UC by performing an endoscopy?

Are you currently experiencing a flare of UC symptoms? A “flare” or “active symptoms” usually consist of issues like frequent or urgent bowel movements, diarrhea, bloody stool, and/or abdominal pain. You may also experience fatigue, lack of appetite, and weight loss.

Have you ever received a surveillance colonoscopy? A surveillance colonoscopy is one that takes place after a diagnosis of a gastrointestinal (GI) disease or disorder such as UC.

Do you have a diagnosis of Crohn’s disease (CD) or indeterminate colitis (IC)?

Have you been hospitalized in the past 3 months due to a flare of UC symptoms that required intravenous (IV) steroids?

Have you had a partial or total removal of their colon, also known as a colectomy?

Regarding medications to treat UC, please indicate the statement that best describes you.


If you choose to save your information and, if you are submitting information on behalf of someone else, the potential participant’s information, on this website, and we want to contact you in the future about the ELEVATE UC 52 and ELEVATE UC 12 studies, what is your preferred method of being contacted?
Please note, your preference will be taken into consideration, but we may contact you using any methods you provide (SMS, Phone, Email).