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Register with our panel to take part in paid medical market research

If you would like to take part in paid medical market research, please complete our registration form below. Your information will be processed in accordance with the Data Protection Act of 2018 and in compliance with the UK GDPR. Our page How it Works explains more about the procedure and how your information will be used. You can also read our Privacy Policy.

Patient and Caregiver Registration Form

* indicates requiered

Select the Medical Condition (s) you or the patient have been diagnosed with: (Please select all that apply)

Allergy (e.g.hayfever, food allergy etc.)

Alzheimer's Disease


Attention Deficit Hyperactivity Disorder (ADHD)

Autoimmune Disease - Crohn's Disease

Autoimmune Disease - Lupus

Autoimmune Disease - Multiple Sclerosis

Autoimmune Disease - Psoriatic Artritis

Autoimmune Disease - Rheumatoid Arthritis

Autoimmune Disease - Ulcerative Colitis

Autoimmune Disease - Other (Please specify below)


Bladder Condition (e.g. OAB, Incontinence etc.)

Bladder Condition - Other

Blood Pressure - High

Blood Pressure - Low

Cancer - Breast Cancer

Cancer - Colon Cancer

Cancer - Lung Cancer

Cancer - Prostate Cancer

Cancer - Other (Please specify below)

Chronic Fatigue Syndrome / ME

Diabetes - Type 1

Diabetes - Type 2



Erectile Dysfunction / Impotence

Eye Condition - Cataracts

Eye Condition - Long Sightedness

Eye Condition - Short-Sightedness / Myopia

Eye Condition - Other (Please specify below)


Gastric Condition - Irritable Bowel Syndrome (IBS) / IBD

Gastric Condition - Other (Please specify below)


Hepatitis A

Hepatitis B

Hepatitis C

High Cholesterol


Hypothyroidism or Thyroid Disorder



Lung Condition - Asthma

Lung Condition - Bronchitis

Lung Condition - COPD

Lung Condition - Emphysema

Lung Condition - Peripheral Vascular Disease

Lung Condition - Other (Please specify below)


Muscle / Joint Condition - Ankylosing Spondylitis

Muscle / Joint Condition - Polymyalgia

Muscle / Joint Condition - Arthritis (don't know what type)

Muscle Joint Condition - Other (Please specify below)




Parkinson's Disease

Sexually Transmitted Infection

Skin Condition (e.g. Dermatitis, Eczema, Psoriasis etc.)

Other Conditions (not listed)

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