Woolcock Institute of Medical Research
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Sleep Apnea cardioVascular Endpoints
Development of the Stage Of Change Scale Specific
Development of the short-form Inhaled Corticostero
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Current Research Studies
Sleep apnea and cardiovascular disease
Sleep Disturbances with Asthma & Rhinitis Form
COPD Screening Form
Summer Research Projects
Sleep Honours / Masters
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Research Database Consent Form
Would you like to participate in our medical research?
If your answer is YES, please complete your details below.
If your answer is NO, please leave this form blank.
THIS CONSENT IS VOLUNTARY AND YOU ARE UNDER NO OBLIGATION
I DO consent for my details to be added to the Woolcock Institute of Medical Research Volunteers Database regarding potential participation in clinical trials for medical research. My participation in clinical trials is voluntary and I am under no obligation to participate.
Gender: (please select)
Have you been diagnosed with, or think you may have? (please check for each)
OSA (obtrusive sleep apnea)
RLS (restless legs syndrome)
Other lung disease
COPD (emphysema/chronic bronchitis)
Are you diabetic?
Do you have high blood pressure?
Are you a shift worker?
Have you received any treatment for a sleep disorder?
If so please state what kind of treatment
Do you currently take any medications?
If so, please state which medications
I agree to receive mailings from the Woolcock Institute of Medical Research.
for research study participant privacy statement
Are you expecting your first baby?
Do you have high blood pressure and snore?
Do you have sleep apnea?
Do you have COPD?
Tablet for asthma?
Insomnia sleep study
Can't use CPAP or MAS?
List of Studies
Woolcock Institute of Medical Research - ABN: 88 002198905
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