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Sign up Form

Pre-screening questions:

Step 1 of 14

What is your age?

Do you smoke regularly or use to smoke regularly with cigarettes or cigars?

Do you vape?

Do you have COPD?

Are you a healthy volunteer without COPD and has not smoked?

Are you able to attend the study site at Cambridge Biomedical Campus (Addenbrookes Hospital) in Cambridge?

Are you registered with a GP practice in the UK?

Are you already enrolled in a clinical trial?

Are you currently pregnant, breastfeeding or planning on becoming pregnant in the next 3 years?

Are you happy to have CT scans, blood test and lung function tests as part of the study?

Would you be interested in having the camera test called a bronchoscopy as part of the study?

This test is optional.

Is it ok if we contact you back to arrange a study screening visit to see if you are eligible to take part in the study?

Contact details

Consent and data use

I agree for the Study Team to record my personal information and information about my medical history provided on this form. I agree to be contacted by the Study Team for the purposes of this study.
I understand and agree that the medical information I give here will be recordedstored and used to assess eligibility for the study.

Thank you

Dr Marie Fisk and Dr Martin Knolle

Please contact us at xxxx for further information.

Cambridge University Hospitals NHS Foundation Trust (CUH) is the Sponsor for this observational study based in the United Kingdom. will be using information from you to send you further information about this study and will act as the data controller for this purpose. This means that they are responsible for looking after your information and using it properly. If you wish deletion of your records, please contact us to do so at any time. To safeguard your rights, we will use the minimum personally-identifiable information possible. You can find out more about how the Sponsor uses your information using the information below: - For Cambridge University Hospitals NHS Foundation Trust, please visit: https://www.cuh.nhs.uk/corporate-information/about-us/our-responsibilities/looking-after-your-information, or email the Data Protection Officer at: [email protected]