To determine if you qualify for a research study, we will ask you some questions about your medical history and present condition. This survey will remain confidential and will be reviewed by the research staff only. This information is for pre-screening purposes only and does not guarantee qualifications for a study. It may be kept on file for futire studies for which you may be eligible. If you do not qualify for a study or choose not to participate, at your request we will destroy the information submitted in this survey.