The code block below illustrates how one might use # and // as comments in your logic and calculations.

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Required format:

RzEmqTYXxfvXdqibTvRpqE

EBS Longterm Outcomes

As a female patient or a caregiver of a female patient with Eagle-Barrett Syndrome (EBS), also known as Prune-Belly Syndrome, we are asking you to complete this survey to help us better understand long term surgical and medical outcomes relating to females with EBS.

Providing your e-mail address is completely voluntary, and your survey response will still be collected if you do not provide one. The main purpose of collecting your e-mail address is so that we can make sure only one survey is completed per person. If you choose to provide an e-mail address, we will also send you any publications created from the results from this survey.

Other than your email address we will not collect any information that will identify you or your child. When publications are made, we will not use your e-mail in these publications.

Completion of this survey is considered your and your child’s consent to participate. This survey is completely voluntary. If you decide not to participate your or your child’s care at Arkansas Children’s will not change.

If you have any questions related to the study. You can contact the PI, Normastel Johnson, of the Study at NJohnson3@uams.edu or the University of Arkansas for Medical Sciences (UAMS) IRB at IRB@uams.edu or call 501-686-5667 during normal business hours

Are you a female with Eagle-Barrett syndrome (Prune Belly syndrome)?

* must provide value

Yes

EBS Longterm Outcomes

You have selected an option that triggers this survey to end right now.