Patient Application Form

If you would like to participate in a clinical trial, please fill out the application form. We will contact you when a trial matching your criteria becomes available.



    I consent to the processing of my personal data provided in the form for the purpose of responding to questions, continuing electronic correspondence, presenting offers, and informing me about promotions.

    Providing my personal data is voluntary, but necessary for correspondence. The administrator of personal data is Collegium Medicum UM. Read more in our Privacy Policy.

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