INFORMED CONSENT DOCUMENT AGREEMENT TO BE IN A RESEARCH STUDY

Challenge/Study Title	BPC-157 for Injury Recovery and Pain: A Citizen Science Trial
Challenge Coach (The Person in Charge of This Research Study)	Efforia Advanced Author
Sponsor	This study is made possible by your payment to join.
Challenge Cost	$0
Included Products & Services	Inflammation Blood Test
Outcome Measures	PROMIS Bank v1.1 – Pain Interference, Inflammation Blood Test, Quality of Life and Health Survey
Contact	help@efforia.com

The Purpose of This Study

We're on a mission to investigate the potential benefits of BPC-157 in injury recovery and pain management. We're hoping to gather valuable data that could shed light on this peptide's role in inflammation and pain relief. We aim to contribute to the body of knowledge surrounding BPC-157, and your involvement will help us do just that. So, if you're up for a bit of citizen science, come join us!

Your Responsibilities as a Participant

This study is perfect for individuals suffering from chronic pain or recovering from injuries. As a participant, you'll be asked to take an inflammation blood test and complete a series of health surveys. You'll also need to provide regular updates on your pain levels and overall health status. We ask that you be consistent and truthful in your reporting to ensure the validity of our findings.

Your Rights as a Participant

Let's make it clear: participation is entirely voluntary. You have the right to opt out of the study at any point in time. However, please note that refunds for the joining fee are not available. Your participation, or lack thereof, will in no way affect your relationship with Efforia.

How to Leave the Study

To exit the study, navigate to your Profile page, select “Your Challenges” and click “leave”. Please keep in mind that the fee you paid to join the study is non-refundable. This payment is crucial in maintaining the integrity of the study for other participants.

Risks and Benefits

Participation in this study may involve some risks, such as potential side effects from the BPC-157 and mental discomfort from answering personal health questions. However, you may also benefit from gaining a better understanding of your health and receiving personalized outcome reports. We advise consulting with a healthcare professional if you have any concerns. Remember, if you ever feel suicidal, reach out to the National Suicide Prevention Hotline at 988. Please note that this study does not provide a medical diagnosis or cure, and some insurance plans may not cover research-related injuries.

What to do if you have an adverse event or medical emergency

In case of a medical emergency or adverse event, seek immediate medical attention. Please do not attempt to contact Efforia, the community or study sponsors until after you’ve sought care. Once you've received medical help, please report any adverse events to help@efforia.com.

Data Protections

During this study, we will collect data related to your health, pain levels, and survey responses. This data will be accessed only by authorized individuals and used to provide you with personalized reminders, outcome reports, and overall findings. All data is stored securely. However, as this is a community study, we encourage you to share your experiences with others in the study and the wider world. You can adjust your communication preferences at any time. Please review Efforia's Terms & Conditions and Privacy Policy for more information.

If you have questions

Got questions? Don't hesitate to engage with our community - that's what it's here for! Alternatively, you can contact help@efforia.com for private inquiries.

California Experiential Research Subject’s Bill of Rights

As a participant in a research study in California, you have certain rights. These include the right to be informed of the nature and purpose of the study, to decide to participate or not without pressure, to receive a copy of the signed and dated consent form, and to ask any questions about the study at any time.

HIPAA Waiver

By participating in this study, you waive your rights under the Health Insurance Portability and Accountability Act (HIPAA) to the extent it applies. This means that your health information gathered during this study may be used and disclosed for research purposes.

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1. Authorization and Consent for Diagnostic Testing
2. I voluntarily consent and authorize CWI Physician Partners P.C., a California professional corporation; CWI Physician Partners P.C., a Hawaii professional corporation; CWI Physician Partners P.C., a Georgia professional corporation; CWI Physician Partners P.C., a Kansas professional corporation; CWI Physician Partners P.C., an Oregon professional corporation; CWI Physician Partners P.C., a Nevada professional corporation, CWI Physician Partners P.C., a Rhode Island professional corporation; CWI Physician Partners P.C., an Oklahoma professional corporation, as applicable ("CWI") to review the collection, testing, and analysis for the purposes of a diagnostic screening test. I understand that there are risks and benefits associated with undergoing a diagnostic screening testing and there may be a potential for false positive or false negative test results. I assume complete and full responsibility to take appropriate action with regards to my test results. Should I have questions or concerns regarding my results, or a worsening of my condition, I shall promptly seek advice and treatment from an appropriate medical provider. I further acknowledge the following:
   1. I am the individual who will provide the sample for the Test(s) that I am requesting or I am the parent or legal guardian of a minor who is providing the sample for testing.
   2. I am at least eighteen (18) years of age or I am the parent or legal guardian of a minor who is providing the sample for testing.
   3. I have read and understand the information provided about the Test(s) that I have been provided on the website where I requested the Test.
   4. The information I have provided in connection with my request to CWI is correct to the best of my knowledge. I will not hold CWI or its employees or agents responsible for any errors or omissions that I may have made in providing such information.
   5. My health information and results may be shared with CWI employees and agents for the purpose of ordering, processing, and reporting my results.
   6. Medical Services provided by CWI are purely for diagnostic assistance purposes and do not create a physician-patient relationship, and do not constitute medical care or diagnosis or treatment of any condition, disease, or illness.
   7. I authorize CWI to contact me via text message to communicate with me regarding my test.
3. Patient Rights and Privacy Practices
   1. Notice of Privacy Practices and Patient Rights: CWI Notice of Privacy Practices describes how it may use and disclose your protected health information for other purposes that are permitted or required by law. To review a copy of CWI Notice of Privacy Practices, go to http://www.CynergyWellness.com.
   2. Disclosure to Government Authorities: I acknowledge and agree that my test results and associated information may be disclosed to appropriate county, state, federal, or other governmental and regulatory entities as may be permitted by law.
4. Release
   1. To the fullest extent permitted by law, I hereby release, discharge and hold harmless, CWI, including, without limitation, any its respective officers, directors, employees, representatives and agents from any and all claims, liability, and damages, of whatever kind or nature, arising out of or in connection with any act or omission relating to my diagnostic test or the disclosure of my test results.
   2. By selecting the ACKNOWLEDGEMENT during the registration process for diagnostic testing, I acknowledge and agree that I have read, understand, and agreed to the statements contained within this form. I have read the contents of this form in its entirety and voluntarily consent to proceed with these procedures.