Diagnosis and Impact of POTS

Thank you for your interest in Postural Tachycardia Syndrome research. If you agree to participate in this POTS Survey study, please continue with the survey. The first item on the survey is the consent form. Please click on the consent link and read it completely. If you agree to be a part of this study, please indicate by stating yes at the "agree to consent" question. Please note that the date fields are in the y-m-d format. (year-month-day)

Your individual answers will be kept confidential. You may be contacted in the future for other research studies. If you do NOT want to be contacted for future studies, you will have an opportunity to opt out of any other contact from us.

This survey has 29 pages. During testing, most participants have been able to complete it in approximately 30 minutes. At the end of each page, there are two options: "next page" saves your answers and allows you to proceed to the next page. "Save and return" allows you to temporarily stop the survey. You will be sent a URL with information on how to return to the survey when you are ready to continue.

If you need to stop the survey and return at a later time to complete, please click on "Save and return” at the bottom of the page. If you do not click on "Save and return”, you would have to start the POTS Survey from the beginning to participate.

If you are under the age of 18, you will need a parent or guardian complete the questionnaire for you.

This study has been approved by Vanderbilt Medical Center Institutional Review Board (IRB#140303).

If you have any further questions about this survey, you can send them to rajlab@vumc.org.

Thank you for your participation.

Alfredo Gamboa MD MSCI and Satish R Raj, MD MSCI

Vanderbilt University Medical Center

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