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Patient Partnership Program

Screener Landing Page 1

Would you like to join the Patient Partnership Program?

Recruitment into the Patient Partnership Program is a two-step process.

First, we ask that you answer a few simple questions in this website. This should take no more than 10 minutes.

Based on your responses to the following questions, you may be invited to join the program. If so, we will ask for your consent in order to contact you and gather additional information in a telephone call or virtual meeting. At this meeting you will have a chance to ask us questions about the program and we will be able to discuss your suitability to become a member of the program. If we both agree, you will be invited to formally join the program and have a no-obligation opportunity to take part in different patient partnership projects.

If we don’t currently have a program which is suitable for you we will let you know with a message on this website. We may invite you to share your details with us should such a program become available in the future.
 
Are you 18 years or older? *This question is required.
1. Are you applying as a patient or a caregiver? *This question is required.
Do you have parental authority for the minor you care for? *This question is required.
Do you speak and read English fluently? *This question is required.
2. What other languages apart from English do you fluently speak? *This question is required.
3. Do you have any of the following health conditions or care for someone who does? (Select all that apply) *This question is required.
4. 8. Are you or anyone in your immediate family currently employed by a pharmaceutical or medical device company, or a regulatory body approving medicines in your country (such as FDA in the US, MHRA in the UK or the EMA in Europe)? *This question is required.
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