Janssen Research & Development, LLC is currently looking to evaluate the efficacy and safety of an investigational medication in pregnancies at risk for severe hemolytic disease of the fetus and newborn (HDFN). Below is a questionnaire for you to complete to see if you may be eligible for further pre-screening for the clinical trial. Please note all questions are required in order to submit the form. This questionnaire is intended for United States participants only.

Clinical Trial Media, our affiliates, and our service providers will use your responses to these questions to determine your potential eligibility to participate in the screening for this trial and, perhaps other trials for which you may be eligible, and to contact you. If you are found potentially eligible, we will share these responses and the contact information that you provide with the staff of the trial clinic that you select. Our Privacy Policy further governs the use of the information that you provide.

Privacy is very important to us. The information you provide will only be used to inform you of clinical research trials for which you may qualify. Any personal information you provide to us in connection with clinical research opportunities is captured and transmitted through a secure network connection to a secure database and retained in the United States. If you do not qualify for this study, your information will be retained, with your consent, for future research opportunities. You may withdraw your consent at any time by contacting privacy@clinicaltrialmedia.com.