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.
Patients must have a safety contact person, in case of suicidal expressions.
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 advice is 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 *

I agree to receive SMS messages from the Rapid Improvement study for verification and enrollment-related communication. Reply STOP to opt out.

Your mobile phone number must have exactly 10 digits (US). Example: 472-253-0714.

If you do not receive a text message with the code 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.

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.

A third party must monitor your interactions with the AI system. This person can be a clinician, a family member, or a close friend. They will receive a text message with safety instructions, including what to do if the system is misbehaving or if you express suicidal intent and plans. You must obtain this person’s agreement before you continue.

If you do not have someone you can ask, then during business hours—and based on volunteer availability—we may be able to assign a volunteer monitor.

I do not have a person to suggest. I am requesting a volunteer monitor (business hours; based on availability).

Name of monitor *

Please provide the monitor’s name, or request a volunteer monitor.

Monitor cell phone (can receive texts) *

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

— Emergency Contact

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.

— Your Clinician

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’s system advice and make sure it is appropriate for you?

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

— Confirmation

Please review your answers before continuing. Project staff may contact you by phone or email to verify your eligibility. If you are eligible, you will be directed to the consent page.

* 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.