SND11 Prescreening

We are prescreening for the SND11 study on Schizophrenia in Adolescents. The purpose of the study is to evaluate the safety and effectiveness of an investigational drug called NaBen® for the treatment of Schizophrenia in Adolescents. Participation in this study would last about 10 weeks and would require up to 7 visits to a study site.

To see if your child meets the preliminary criteria for this study, we need to ask you some questions about your child’s health history and present condition. You do not have to answer any questions you do not want to answer. If your child qualifies for this study, you can find a study site close to you by “Finding a Trial Site.” You can also contact toll-free number 866-971-0917 to speak to one of the study staff about the study, eligibility to participate, site referrals, etc. We will refer you to a local study site if applicable for further study procedures if you choose to. You can choose to discontinue your cooperation with the site at any time, and can ask the site not to call you again if you decide to. Do you like to proceed to prescreening?

Thank you for your time. We will not contact you again. Have a good day.

Thank you. We will start by asking you some questions, remember that you do not have to answer any questions you do not want to:

1. Is your child between the ages of 12 and 16?

YES NO
2. Is your child diagnosed with Schizophrenia?

YES NO
3. Is your child diagnosed with any of the below conditions?

YES NO
- Dissociative disorder
- Bipolar disorder
- Major depressive disorder
- Schizoaffective disorder
- Schizophreniform disorder
- Autistic disorder
4. Is your child receiving medications for attention-deficit hyperactivity?

YES NO
5. Does your child have a history of Epilepsy?

YES NO

Thank you for answering our questions. Based on the answers you provided, your child meets the preliminary criteria to attend in our study, pending more detailed screening by the local study site doctor. You can also call 1-866-971-0917 for further information.

Thank you for answering our questions. Based on the answers you provided, your child does not meet the preliminary criteria to attend in our study. However, the prescreening is preliminary. You can call 866-971-0917 for further information and confirmation.

1. Is your child between the ages of 12 and 16?

2. Is your child diagnosed with Schizophrenia?

3. Is your child diagnosed with any of the below conditions?

4. Is your child receiving medications for attention-deficit hyperactivity?

5. Does your child have a history of Epilepsy?