clinical research prime

Household Influenza Treatment Study

Between the ages of 5-64
Diagnosed with Influenza
Had symptoms for 48 hours or less
Participants will receive study related treatment at no cost and will be compensated for time and travel

Patient Info *

First

Last

Date of Birth *

Phone *

Email *

Do you have a current positive influenza A or B test? *

Are there children in your household under the age of 2? *

Do you have a negative PCR Covid test? *

Do you have asthma? *

Preferred Language

Please review my questions and contact me with further information for this study. *

Between the ages of 1-12
10 week duration
Participants will receive study related treatment at no cost and will be compensated for time and travel

Patient Info *

First

Last

Date of Birth *

Parent/Guardian Info *

First

Last

Phone *

Email *

Does child have a positive Influenza A or B test within the last 24 hours? *

Is child currently taking Tamiflu or other antiviral medications for the flu? *

Preferred Language

Please review my questions and contact me with further information for this study. *

IDAHO FALLS

Monday-Thursday 8am-5pm & Friday 8am-2pm

187 East 13th Street
Idaho Falls, ID 83404

REXBURG

By Appointment Only
420 E 4th N
Rexburg, ID 83440

Call: (208) 497-0600
Text: (208) 508-1467
Fax: (208) 497-0606

SOCIAL MEDIA