Middlemore Clinical Trials
Private Bag 93311 New Zealand,
+64 9 270 9758  http://www.middlemoretrials.nz
Crohn's Disease (M15-991)
Thank you for your interest in participating in an investigational product clinical trial with Middlemore Clinical Trials. This is simply a quick check to see if a study may be suitable for you. Please answer the following questionnaire and enter some information about yourself or call us on 0800 27 27 84. One of our research nurses will be in touch with you within 24 hours (weekdays only) to provide you with more details. As a health provider, we comply with the Health Information Privacy Code (1994), so the information you send will be stored securely and will not be shared other than as required for trial purposes. By sending us this information you agree to be registered on our participant list to be contacted about future trial opportunities and relevant trial information.

Please answer the following questions:
QuestionAnswer
Have you been diagnosed with Crohn's disease for at least 3 months?
Do you currently have Crohn's symptoms including moderate to severe abdominal pain and/or daily unformed stool frequency >4?
Have you previously tried Crohn's medications (eg Infliximab or Humira) but still have symptoms?
Have you had an ileostomy or colostomy?
Do I pre-qualify?
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