Please complete this form if you are interested to participate in clinical trials for future. You have the right to request access to, and corrections of, any personal data concerning you held by DOKUMEDS, as well as to discontinue the cooperation and request withdrawal from DOKUMEDS database.

Please specify your experience in clinical trails

14 + 2 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.