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MODULATE Self-Screening

Date

Welcome to your MODULATE Self-Screening

Are you aged 18 years or over and live in the UK?

Do you suffer from ulcerative colitis?

Have you been told your disease is currently stable but, despite this, your condition still causes you frequent, troublesome diarrhoea?

Have you ever tried to treat your ulcerative colitis with regular use of any of the following treatments, but this didn’t seem to help relieve your symptoms?:

Do you have any known allergies to: