Guanfacine Study Interest Form

We are offering a 7-week Research Study opportunity for people between the ages of 18-55 that are struggling with Opioid use and are currently maintained on Buprenorphine.

Help us study a medication called Guanfacine and a mindfulness therapy to reduce opioid cravings.

We are offering compensation of approximately $450.

Visit the Study website for more information.

Please fill out the form below and we will get back to you as soon as possible to schedule an initial phone screen. All information you provide is confidential.

Full Name*

First NameLast Name

Phone Number*

E-mail*

example@example.com

Are you between the ages of 18 and 55?*

YesNo

Are you currently taking Buprenorphine?*

YesNo

Are you currently taking any medication(s) for high blood pressure?*

YesNo

Do you want to cut back on using substances?

YesNo

Preferred DAY to contact you (Please select all that apply)

Preferred TIME to contact you (Please select all that apply)

What is your preferred method of contact? (Please select all that apply)

EmailPhone CallText