Nuclear Veterans Study Registry 2019
Email address *
This form is to register for an Otago University study into the health of nuclear veterans and their children. By filling in this form you consent to your information being passed on to Associate Professor David McBride, head of the study, and any academic staff and/or post graduate students who are called upon by Professor McBride to assist in conducting this study. The information will only be used for the purposes of communicating with you for the study when the study into your health and the health of your descendants (children, grandchildren and great grandchildren) is ready to be conducted. All information shared in this form will be collected and shared with Professor McBride and his team.
Name *
Your answer
Email *
Your answer
Address *
Your answer
Home phone number *
Your answer
Mobile phone number *
Your answer
Please state your connection to the study *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy