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Joining Phase 1 Clinical Trials

Personal Information Collection (PIC) Statement

Clinical Trials Centre, The University of Hong Kong (HKU-CTC) invites you to provide your personal information. The information provided would be used in determination of your participation in clinical research studies organized by HKU-CTC. Upon completion of this form implies that you

  1. are interested in participating clinical research studies organized by HKU-CTC;
  2. agree HKU-CTC has the rights to preserve and process your information in determining your opportunity in participating any clinical research related activities; and
  3. agree HKU-CTC could contact your for future clinical research studies. However, you have no obligation to participate in any clinical study.

If you dedice to participate in any clinical study, HKU-CTC will provide separate informed consent to you.

Privacy Policy Statement

Information provided in this registration form will be subjected to the Personal Data (Privacy) Ordinance (the "Ordinance") protection. Your information will be stored in a confidence way by HKU-CTC, and only for the above-mentioned purposes. Your data will not be disclosed to any third party without your prior consent. Under the Ordinance, you have the rights to request access to and / or change your personal information. You may send your request to HKU-CTC commissioner of protection of personal data (e-mail: pdpcctc@hku.hk ; Tel: 2255 4664). If you have any questions about the rights and interests of the Ordinance, you can contact the Office of the Privacy Commissioner for Personal Data.

Phase 1 Clinical Trials Volunteer Registration Form

Thank you very much for your interest in volunteering to participate in phase 1 clinical trails. Please spend a few minutes in filling the form and we should contact you when there is suitable study.

First name
Last name
Gender
Male   Female
Age
Occupation
Contact tel
Email address
Smoker
Smoker   Non-smoker   Ex-smoker since
Research no./
Research area
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