Volunteer Registration
Register your interest in taking part in paid clinical trials. This does not commit you to participation.
1. Personal information
First name *
Last name *
Email *
Phone *
Age *
Gender *
Select gender
Male
Female
Prefer not to say
2. Height & weight (optional)
Height (cm)
Weight (kg)
3. Lifestyle
Smoking / nicotine use *
Select option
Non-smoker
Smoker
Other nicotine products
Alcohol use
Select option
None
Occasional
Regular
Dietary habits
Select option
Omnivore
Vegetarian
Vegan
Other
4. Reproductive health (if applicable)
Do you use contraception?
Select option
Yes
No
Contraception method
Surgically sterilised?
Select option
Yes
No
Postmenopausal?
Select option
Yes
No
5. Medical background (optional)
Medical conditions
Current medications
6. Recruitment information
How did you hear about us?
Select option
Website
Google
Social media
Friend
Doctor
Other
Previously registered with us?
Select option
Yes
No
7. Consent *
I confirm I am 18 or over *
I agree to the Privacy Policy *
I consent to processing of medical data *
Register interest
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