Join the registry
One form, and then we leave you alone
Everything except a way to contact you is optional. A sparse record is still a useful record, and you can fill in the rest whenever you like.
Registry enrolment
Only the first three fields are required.
You are on the registry.
We have your record. You will not hear from us again unless a study matches it, or unless you ticked one of the message boxes above.
What happens to this form
It goes to the registry team and nowhere else. It is not passed to a sponsor, a research site or a marketing company. Read what we hold and what you can ask for.
Joining is not consent to research
Taking part in a study means signing an informed consent document at the research site, after someone has gone through it with you. This form is not that, and does not lead to it without another decision from you.
This form is not for urgent problems.
If you are in a crisis, or have chest pain, breathlessness, fever or sudden weakness,
contact your care team or emergency services now. Nobody monitors this form out of
hours.