Sign up to Pathway to Research

Last updated: Tuesday 10 September 2024

Before completing this form please read the information on Pathway to Research.

By completing this questionnaire, you are agreeing to your information being added and retained by the Research and Development (R&D) Pathway to Research Team. This will allow us to contact you directly about research opportunities.

Please complete as much of the questionnaire as you are comfortable with to help us share studies that might be suitable for you.

If you would like any help completing this form, please contact the team by calling 01928 753303 or emailing whh.halton.cru@nhs.net.

Once you have completed the form, a member of the team may get in touch by phone or email if further information is needed.

 

For example, 15 3 1984
Gender
Please provide height in feet (ft) and inches (in) or centimetres (cm)
Please provide weight in stones (st) and pounds (lb) or kilograms (kg)
Do you have any allergies?
Do you have any medical conditions?
Are you a patient at Warrington and Halton Teaching Hospitals NHS Foundation Trust? * This includes Warrington Hospital, Halton Hospital Nightingale Building, Captain Sir Tom Moore Building or any other location in the community where the Trust provides services.
Are you happy to receive newsletters from the Pathway to Research Team? *
Are you happy to receive information on research opportunities from WHH partners? * We will send opportunities direct to you and will not pass on your details to any third parties.