May we please contact you?

Thank you for selecting a study center. Next, we’ll need some additional information for the study center to contact you.

The information you provide will only be shared with our study team at the center you selected. This way, the study center can contact you to schedule your upcoming visit.

It is important to remember that your study participation is completely voluntary, and you can choose not to participate at any time. If you choose not to take part, please inform the study team.

Please provide your contact details in the form below. All fields marked with a * are required.

* First Name:

* Last Name:

* Email Address:

What happens to my Personally Identifiable Information (your contact details)?

What happens to my Personally Identifiable Information (your contact details)? The information you submit, including your Personally Identifiable Information (PII), will be processed, then stored on a secure server within the European Union. This information is then used to connect you with clinicians at the trial centre. This involves sharing your PII with the relevant trial centre. Only the trial centre staff can access and view your information. Please visit our Privacy Policy to learn more.

* I have read the information above and I consent to the processing of my personal data for the above-stated purpose.

Do you agree to have our study team contact you to discuss the study in more detail?

* I agree to have the study team contact me.

We are committed to keeping your personal information safe and secure. Please see our Privacy Policy.