開始註冊 名 *姓 *電話號碼電郵地址 *單位、大廈街道及號碼區域城市、県、省郵政編號國家、地區AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChina, People's Republic ofChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrance, MetropolitanFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJerseyJohnston IslandJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarReunion IslandRomaniaRussiaRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre & MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSpainSri LankaStateless PersonsSudanSudan, SouthSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwan, Republic of ChinaTajikistanTanzaniaThailandTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks And Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwe性别 *男性女性出生日期 *身高(cm) *體重(kg) *有沒有吸煙的習慣?有沒有過往的醫療紀錄有沒有醫療紀錄(如有)有沒有註冊過其他臨床試驗機構? *有沒有請在此列出你曾註冊的臨床試驗機構(如有)請在此列出你曾註冊的臨床試驗機構(如有)您有沒有參加過臨床試驗? *有沒有你是怎樣認識本公司的? *Google SearchFacebookInstagramNewspaper (報章)A Friend (朋友介紹)Event (活動)Content Creator(創作者)其他請註明請註明你曾經參與的活動及地點”Event (活動)請註明你曾經參與的活動及地點”Event (活動)請註明你曾經參與的活動及地點”Event (活動)如果您過去曾參加過臨床試驗,請在此列明試驗地點和時間。例如: 20xx 年 3⽉12日 9:00a.m. 倫敦By registering your interest with Chinese Medical Research, You agree for our company to retain your data within our subject / participant database in complete confidence and protected by UK Data Protection Act, General Data Protection Regulation (EU) 2016/679 and all applicable USA / global data protection laws. You are agreeing to Chinese Medical Research using this information to contact you for clinical studies you may eligible for. You are agreeing that your information may be shared with other Clinical Research Units which are conducting clinical studies which you are interested in. You are agreeing that your information can be sent to the Clinical research units in advance of your screening visit, as part of booking you an appointment for study specific medical screening process. The information will be securely stored on the Clinical Research Unit volunteer database in Europe or Non-EU country (e.g. USA) Please note that this data will not be shared with any third party without your permission therefore in order to register you onto our database we require your consent and permission to share your information in confidence, as stated above. We will only share your information with Clinical Research companies / clinics conducting studies which you are wishing to participate in. You may obtain your record or request to delete by writing to us via email or directly via our Chinese Medical Research app if you have downloaded and registered via the Chinese Medical Research app. * 在Chinese Medical Research註冊,代表 您同意將個⼈資訊保存在本公司志願者資料庫中。資料會受英國資料保護法、通⽤資料保護條例 (EU) 2016/679 和所有適⽤的美國/全球資料保護法保護。 您同意Chinese Medical Research使⽤上述資訊與您聯繫,以瞭解您是否有資格參加臨床研究。 您同意當您對某該臨床研究有興趣時,你的資訊可能會與該臨床研究機構共用。 您同意我們將您的資訊發送到臨床研究單位,為您預約篩查體檢。您的資訊會安全地儲存在歐洲或⾮歐盟國家(例如美國)的臨床研究單位的資料庫中。 未經您的許可,我們不會與任何其他第三⽅共用此資料,因此我們需要您的同意和許可,才能記錄您的個人資訊,並分享與相關機構。 我們只會與您希望參與的臨床研究的相關公司、中心或診所共用您的資訊。 您可以通過電⼦郵件向我們查看您在我們資料庫中的個人記錄,或要求將其刪除。 *本⼈明白及同意上述事項,並同意提交上述個人資訊予Chinese Medical Research,及確保上述資訊真確無誤。註冊