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You give permission to Clinago, powered by Indero, to use the personal and health information that you include in this form, for the purpose of evaluating your application to participate in this research study.

We will only maintain and process the information you voluntarily provided to us in this form and you authorize Clinago, powered by Indero, to transfer your personal and health information to the clinic you selected on the previous page.

Except for the transfer to the clinic you selected, your personal and health information will not be shared with others without your permission, unless permitted or legally required.

Please note that your consent does not have an expiration date; however you may withdraw it at any time, noting that any use and/or transfer of your personal and health information made before your withdrawal remains legal and valid.

If you want to revoke your consent or if you want to exercise any of your rights (correction, deletion, consulting) or have any inquiry related to our processing of your personal and health information, you must write to: Indero, to the attention of its Privacy Officer, at privacy@inderocro.com.

You may also file a complaint with your local data protection authority if you think our processing of your personal and health information violates your right to data protection.

You further authorize Indero to keep your personal and health information in our database, so that we can contact you via phone, email, text message or letter, in order to present you with studies that might be of interest to you.

For further information, please refer to our Privacy Policy.

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There are 2 locations for this study

TEST Site EU

TEST Site BOTH (EU name)

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