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Register for clinical trial Cholestatic liver diseases

Enter your details

With this form you register yourself for this trial. Registering only takes a few minutes. Your registration is completely without obligation. When you register, our team will review your information. Call ICON to discuss your registration for the trial and further pre-screening.
Sie müssen Englisch oder Niederländisch sprechen, verstehen und lesen können, um an einer Studie teilnehmen zu können.

Previously registered at ICON?

First name*
Preposition
Last name*

Gender*

Tag*

Tag*

Monat*

Monat*

Jahr*

Jahr*

Land*

Land*
Enter your address here.*
Street name*
House No.*
Postal code*
City*
Mobile phone number*
E-mail address*

Do you smoke?*

How much do you smoke? Select tobacco consumption

How much do you smoke? Select tobacco consumption

Do you have a medical condition?*

What medical condition(s) do you have and medicines do you use?

Are you currently under the treatment of a doctor?*

Please state why you are under the treatment of a doctor.
Height (in cm)*
Weight (in kg)*
BMI
Do not provide additional sensitive or medical personal information here.

Data protection

ICON plc is the data controller of the personal data, including health data, you choose to provide. We rely on your consent to use this information to identify potentially appropriate clinical trials for you and contact you about them.

You can withdraw your consent at any time, for example by contacting us through our contact form or by telling a member of our recruitment team when speaking with them.However, the processing of your information before withdrawing your consent remains lawful.

Additional information on how your data will be processed and how you can exercise your rights, can be found in our Privacy Policy.

Please confirm if you consent to ICON plc collecting and using your personal data for the above purposes. *

- Revised 9 december 2024

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You will receive a confirmation of your registration at the specified e-mail address.

First name*
Preposition
Last name*

Gender*

Tag*

Tag*

Monat*

Monat*

Jahr*

Jahr*
Mobile phone number*
E-mail address*

This site is protected by reCAPTCHA and the Google, Privacy Policy and Terms of Service apply.

Four reasons to register for this study:

  • 1

    No new medicines without clinical research

    New or better medicines are crucial to all of us, but even more so to patients who rely on medicines.

  • 2

    You receive a nice reward

    We offer you a nice compensation for your contribution!

  • 3

    Time to relax, work or study

    While you are at the research center you have time for yourself. Make it useful or use the time just to relax!

  • 4

    Have fun together

    You can do all sorts of things in the research center: play a game with others or enjoy gaming.

  • Was sind Arzneimittelstudien?
  • Wie funktioniert es?
  • Sind Arzneimittelstudien sicher?
  • Vergütung
  • Fakten und Mythen
  • Blogs & News

  • Erfahrungsberichte
  • Die Studien
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  • Kontakt
  • Registrieren bei ICON

info@iconarzneimittelforschung.de

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