We conduct various types of studies at any given time, all within the field of dermatology. Your participation in a research study is protected by HIPAA laws as well as being protected by ethical boards. Your name is never used on study documents/samples, and insurance is not required to participate. In addition, most studies offer compensation to account for your time spent volunteering in the study.
We are currently seeking participants for the following studies: acne, atopic dermatitis (eczema), hydradenitis suppurativa, and psoriasis. Some of our past studies have been on rosacea, cutaneous lupus, warts, chronic hand eczema, in addition to the conditions mentioned above. If we don’t currently have a study that you meet the criteria for, you may wish to be in our clinical trials database. Please click here to print and complete the form. We conduct both pediatric and adult studies, so feel free to complete a form on everyone in your family! We are contacted frequently about new studies, and may have one for you in the near future!
CLINICAL TRIALS INTEREST FORM
If you would like to be contacted in the future regarding potential study participation, please complete this form. We are starting new studies on various conditions all the time!
Pt. name: ________________________________ Phone number(s): (____)________________
Address: __________________________________ City: ___________ State: _____ Zip: ______
E-mail: ____________________________________ Height: _______ Weight: _______
Date of birth: _____________ Age: ________ Sex: ____ (M/F)
Allergies (including drug): _____________________________________ Smoke: _______(Y/N)
Women: Date of last menstrual period: _________________ Hysterectomy: ______(Y/N)
Derm Conditions (including diagnosis dates):_________________________________________
Medical History (including diagnosis dates):__________________________________________
Surgical History (including dates): __________________________________________________
THANK YOU!Fax: 479.876.8049
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