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Jadewell Long COVID Observational Research Program - Participant Consent

Who is running this studyThis study is run by Jadewell, Inc., a company that sells personalized Chinese Herbal Medicine formulas. Jadewell is paying for the study and has a financial interest in its results. The study has not been reviewed by an institutional review board (IRB).

Why we are doing itWe want to learn how adults with Long COVID feel over 90 days while taking a personalized Chinese Herbal Medicine formula. The results will help us design a larger, more rigorous study.

What you will be asked to do

• Complete a baseline survey before you start (about 20 minutes). • Take your formula as directed for 90 days. • Complete a weekly check-in survey. • Complete a shorter survey at days 30 and 60, and a full survey at day 90. • Join a monthly check-in by video call, or send written responses if you prefer.

About the product Your formula is a dietary supplement. These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This study cannot show whether the formula works, because there is no comparison group.

This is not medical care Taking part does not replace care from your own clinician. Keep taking your prescribed medications unless your clinician tells you otherwise, and tell your clinician you are taking an herbal formula.

Risks

• Herbal formulas can cause side effects, such as stomach upset, nausea, diarrhea, rash, headache or dizziness. Rarely, herbs can affect the liver or interact with medications. • Stop taking the formula and seek medical care if you notice yellowing of your skin or eyes, dark urine, severe abdominal pain, or an allergic reaction. Then tell us at care@jadewell.me. • Completing surveys takes mental effort and may worsen fatigue or trigger a crash. You can pause and rest at any time. • Some questions ask about your health and mood and may be uncomfortable. You may skip any question you do not want to answer. • As with any online data collection, there is a small risk of a privacy breach.

Benefits You may or may not feel better during the study. Your answers will help improve future research on Long COVID.

Cost and discount You will pay half price of the standard cost ($59.99): $29.99 for your formula during the 90 days, provided you complete each month's survey and check-in. If you complete all of them, you keep the half-price rate for one year. If you withdraw from the research program, you will not receive the half-price rate further.

Your information

• We collect your survey answers, check-in notes, formula record, and contact details. • Your answers are stored under a study ID number, separate from your name where possible. • Only the Jadewell study team can see information that identifies you. • We will use combined, de-identified results in a written report (white paper), in presentations to investors and partners, and in applications for research funding. • We may share de-identified data with academic research partners. • We will never publish your name or anything that identifies you, and we will not use your individual story or words in marketing without asking you separately. • We will keep study data for 3 years.
How your data is stored and protected Your survey answers are collected through Tally, an online form service, and stored in a private database owned by Jadewell. Your answers are filed under a study ID number. The list that links study IDs to names and contact details is kept in a separate file. Access to both is limited to the Jadewell study team, through password-protected accounts with two-step verification. We do not sell your data or share it with advertisers. Results are reported only in combined form, so no individual can be identified. We will keep study data for 3 after the study ends and then delete it. No online system is completely secure, and we will tell you promptly if we learn of a breach involving your information.

Taking part is voluntary You can stop at any time, for any reason, by emailing care@jadewell.me. If you withdraw, we will keep the data already collected unless you ask us to delete it.

Questions or problems Contact Aria Ma, Jadewell, at aria@jadewell.me or 410-978-8298. In a medical emergency, call 911. If you are in crisis, call or text 988.

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