Complete this form to express your interest
Clinical trials have inclusion and exclusion criteria, so we need to ask a few questions to see if you are eligible.

If you are eligible, we'll get in contact ASAP and provide you with the full details of the study. If not, we can keep you in mind for future studies.

If you prefer, you can just give us a call on 03 9509 6166 or email us at and ask for more information on our studies.

By completing the questionnaire below, you acknowledge acceptance of our privacy policy which can be viewed here:
Email *
Please answer these questions so we can assess your eligibility...
Have you been diagnosed with giant cell arteritis or temporal arteritis?
Clear selection
In what year were you born? *
First Name *
Last Name
Phone number *
So that we can connect with you, what DAY is best for us to call?
Clear selection
What is your preferred TIME for us to call?
Clear selection
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.