Eligibility Determination – George Mason University

On this page we collect information needed to decide whether you can use this system and to verify your contact information. This page is separate from the consent page.

To be eligible for this project, all of the following must be true:

You are between 18 and 85 years old.
You have been diagnosed with Major Depressive Disorder by a clinician, or you have symptoms that can be classified as depression.
You do not have a clinically diagnosed bipolar disorder.
You must provide a safety contact person in case you express suicidal thoughts.
You must either live in a state where the study clinicians are licensed to practice, or have a primary clinician who can review the study recommendations.
You have a primary care provider, a mental health specialist, or agree to see a participating clinician.

You must be between 18 and 85 years old to participate.

Why we ask: We ask for your age to confirm that you are within the age group for which this study was developed. Our data and recommendations are specific to this age group only.

Age *

Please enter a valid age between 18 and 85.

Have you been diagnosed with, or are you likely to be diagnosed with, moderate to severe Major Depressive Disorder, without signs of bipolar depression? *

Yes No / Not sure

Are you using this system from a device located in the United States? *

Yes No

Are you currently in active suicidal crisis or at risk of suicide in the next 3 hours? *

No Yes

If you answer “Yes”, you will not be able to use this system. Please call the National Suicide & Crisis Lifeline at 988.

Are you using your own personal phone or computer (not a shared or public device)? *

Yes No / Not sure

This helps us protect your privacy and keep your information secure.

Our recommendations are different for pregnant patients. Are you currently pregnant or planning to become pregnant? *

Yes No

This helps us tailor medication-related advice safely.

We use this information only to verify your identity and to contact you about the project. It is stored separately from your medical history.

Why we ask: We use your email and phone to confirm it’s really you (via a one-time code) and to send study updates and payment-related messages.

Email address *

We may email your survey payments and project updates to this address.

If you do not receive an email with the code within 1 minute, please check that your email address is correct or try again. If this continues to happen, please call project staff at 472-253-0714 between 9 am and 9 pm Eastern Standard Time.

Please enter a valid email address in the format name@example.com.

Mobile phone that can receive text messages

If you would like to receive a one-time verification code by text message, please provide a mobile phone number and check the consent box below. If you do not provide this information, you will not receive text messages and may not be able to complete phone-based verification for study enrollment.

I agree to receive SMS messages from George Mason University's Rapid Improvement Study for identity verification and enrollment-related communication associated with study participation. Message frequency varies. Message and data rates may apply. Reply STOP to opt out. Reply HELP for assistance.

After you request a verification code, we will send a one-time text message to this number. If you do not receive a text message within 1 minute, please check that your mobile phone number is correct or try again. If this continues to happen, please call project staff at 472-253-0714 between 9 am and 9 pm Eastern Standard Time.

See our Privacy and Terms of Service .

Street address *

Why we ask: Your address is required if you choose to participate in the study so that we can provide the $20 payment for each completed monthly depression survey.

Apartment, suite, etc. (optional)

City *

State *

ZIP code *

ZIP code must be 5 digits.

Please provide contact information for a next-of-kin or a friend that we can share your medical information with, in case the system decides that you are at high suicide risk.

This person is contacted only for safety reasons and is not involved in routine study activities.

Contact name *

Contact phone number *

The Emergency Contact phone number must have exactly 10 digits (US). Example: 472-253-0714.

AI systems can make mistakes. We strongly encourage you to review any recommendations provided by this system with your clinician before making changes to your treatment. Do you have a clinician who can review the AI system’s advice and make sure it is appropriate for you?

Yes, I have a clinician who can review the AI system’s recommendations. No, I would like help finding a clinician who can review the AI system’s recommendations.

Please review your answers before continuing. If you meet the eligibility criteria, you will be directed to the consent form where you can review the details of the study and decide whether you would like to participate.

* I confirm that the information I have provided on this page is true to the best of my knowledge, and I understand that this information will be used only to determine my eligibility and to contact me about this project.

If you become frustrated or have difficulty completing this page, you can contact project staff at 472-253-0714 between 9 am and 9 pm Eastern Standard Time.