support@glucosight.com
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Participate

Would you like to help make blood-based glucose meters a thing of the past?

GlucoSight is looking for individuals to participate in a our research effort. If you are diabetic and monitor your blood sugar daily using meters, strips and lances, we invite you to participate in our research.

There are three (3) requirements to participate:

  1. You must be over 18 years of age
  2. You must have an Android mobile phone
  3. Every participant must have a “Buddy” in their household. This is someone in their household who can also take a measurement three (3) times a day.

If you are chosen to participate, you will be sent a GlucoSight monitor which you and your buddy will use in conjunction with your daily glucose monitoring routine.  Every time you take your sugar reading, you will be required to take a 10 second video of your eye and record the blood sugar level you just measured with your meter.

It’s that simple!

The data collected will be used to as part of research program aimed at eliminating or reducing the use of blood-based glucose monitors.

If you would like to be consider to participate, please submit the form below. Please note this is NOT a clinical trial and your personal information will NEVER be released.  You will be given a unique participation ID and no information will be stored anywhere online. We only want to see your eyes and your sugar. Nothing more. Please call us if you have any concerns or questions.

Name:*
E-mail:*
Age:*
18
18
100
Address:*
Gender:*
Ethnicity:*

We ask that every participant also have a non-diabetic person in their household (their Buddy) who can use the GlucoSight a few times a day to gather addition data.  Please provide their name below.

Buddy Name:*
Ideal Glucose Level:*

I agree to participate in the study conducted and recorded by the GlucoSight, LLC (herein referred to as the Researchers).

I understand and consent to the use and release of the recording by the Researchers. I understand that the information and recording is for research purposes only and that my name and image will not be used for any other purpose. I relinquish any rights to the recording and understand the recording may be copied and used by Researchers without further permission.

I understand that participation in this usability study is voluntary and I agree to immediately raise any concerns or areas of discomfort during the session with the study administrator.

I understand that I must continue to perform the Diabetes maintenance regiment described by my physician and that this research data is no a replacement for my doctors advice. The research being conducted is not a clinical trial and cannot be used or misconstrued in any way to be medical advice or feedback.

I hereby forever waive and release, to the full extent permitted by law, the Researchers from any and all liability, claims, demands, injuries, damages, actions,and causes of action arising from or relating to participation in this research effort. The undersigned is fully aware of the risks involved in such Activities, voluntarily assumes all risks, and releases the Researchers from all liability relating to any accident, mishap, or negligence of the Researchers or any other person or entity.

By checking "Acknowledged" below you indicate that you have read and you understand the information on this form, you are over the age of 18, of sound mind, and that any questions you might have about the research participation have been answered.

Acknowledge:*
Verification: