CHOLECOVID - Declaration of interest
CHOLECOVID is an international multicentre collaborative audit of the management and outcomes of acute cholecystitis during the COVID19 pandemic.

Please register your interest here and we will be in touch soon. Please ensure your details are correct, including specific hospital site you will be collecting data for.

Thank you for your collaboration, we will contact you shortly.
Primary email address of Principle Investigator (please ensure this is your regular email and that it is correct). This will be used to generate your REDCap account. *
First Name (Please ensure this is accurate) *
Last Name (Please ensure this is accurate) *
Official Hospital Name (Please ensure this is not just the university you are affiliated with) *
Hospital Town/City *
Hospital Country *
Secondary email (please provide a secondary email address, either your own or a colleague, in case we are unable to contact you) *
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy