Special study Application

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Altasciences is seeking men and women 18 years and older, suffering from:

  • Type l or ll Diabetes
  • Asthma
  • Hepatitis A, B or C
  • Hepatic impairment
  • Rheumatoid arthritis
  • Low testosterone
Personal information
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eg. 555 444-3333
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Special conditions
In order to better serve you, we must collect some personal information before we can give any details about our current research studies or give you an appointment for your health evaluation. This procedure allows us to verify if you fit the criteria for our clinical trials. Your personal information will be kept under strict confidentiality and only our authorized employees, qualified government agencies and our sponsors will have access to it. You can at all-time contact our Chief Privacy Officer to consult and modify your personal information or to remove your name from our contact list. If you would like to know more about our policy on the privacy of your personal information, please ask for our brochure at the screening center or write to our Chief Privacy Officer at 575 Armand-Frappier, Qc, Canada, H7V 4B3, or email: privacyofficer@altasciences.com or dial this number: (450) 973-6077 or (701) 356-4000. Do you authorize us to collect the required personal information? If you don't agree, we cannot give you details about on-going clinical studies or schedule an appointment with you for a health evaluation.