Clinical Research Facility clinical trial research - Register as a volunteer

Please register your interest for participating in clinical trials/clinical research (studies). The completion of this form will help in our selection process for studies that you may be suitable for, so please complete in as much detail as possible. You will need to register with us online to be able to take part in a clinical trial/clinical research study. 

You must be aged 18 and over to register for clinical trials/clinical research studies. 

Symbols (such as '&') will not be accepted, please do not use these when completing the registration. 

Data submitted via this form will be handled in line with the University of Surrey's Information Management Policies and our Clinical Research Facility (CRF) clinical trial research participant privacy notice

Application and eligibility
You must be eligible to work in the UK to register.
Your name and contact details

Please give us your name and contact details, and ensure that you enter your phone number and your email address.

Name
Address
You must be eligible to work in the UK to register.
Your date of birth and sex
Your height and weight

Use this section to tell us your height and weight and calculate your BMI.

Smoking
Contraception
Your medical details

Please make sure you describe your diagnosed sleep problem in medical conditions.

Previous clinical trials
If you have taken part in a clinical trial before, please tick the box below and provide details, including dates. 
Where did you hear about us?
Where did you hear about us?
How we use your personal information

Any information you provide which can identify you will be added to our Volunteer Database so that we can contact you to assess your suitability to take part in our clinical trials/clinical research studies. All your personal information will be treated as confidential by the Surrey Clinical Research Facility and will be held and processed under secure conditions in accordance with UK and EU data protection laws. We may contact you about clinical trials/clinical research studies by mail, email phone or SMS. If you do not wish to receive details about our services you can opt-out at any time by sending an email to crc-recruitment@surrey.ac.uk and your account will be deactivated and your record will be removed from the database. 

If you take part in a clinical trial/clinical research study with us we may update your record with significant information that emerges from the study (e.g. medical diagnoses or medical history that is likely to affect eligibility for future trials). 

You can update us with any changes to your details by emailing crc-recruitment@surrey.ac.uk

You can find out more information regarding data protection by reading our privacy notice

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