Name: Małopolskie Centrum Kliniczne
Address: ..., Kraków, Małopolskie, 30-149
Telephone: 881 355 639

FORMULARZ ZGŁOSZENIOWY

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Wyrażam zgodę na przetwarzanie przez firmę Małopolskie Centrum Kliniczne moich danych osobowych zawartych w powyższym formularzu rejestracyjnym w celu mojego ewentualnego uczestnictwa w bieżących i przyszłych rekrutacjach do badań klinicznych realizowanych przez firmę Małopolskie Centrum Kliniczne która obejmuje także kontakt drogą elektroniczną (email, sms) i kontakt telefoniczny ze mną jako ochotnikiem do badań klinicznych. zgodnie z ustawą z dnia 18.07.2002 r. o świadczeniu usług drogą elektroniczną (Dz.U. Nr 144, poz.1204 z późn. zm.) i Art. 6 ust. 1 lit. f RODO.
Wyrażam zgodę na przetwarzanie danych osobowych, medycznych i danych o stylu życia do celów pełnej realizacji procesu rekrutacji do badań klinicznych, zgodnie Art. 6 ust. 1 lit. A, c, f RODO oraz art. 9 ust. 2 lit. a RODO w zw. z art. 37 f, a ustawy Prawo farmaceutyczne.
Wyrażam zgodę na przesyłanie mailem lub smsem ofert marketingowych zgodnie z Ustawą z dnia 18 lipca 2002 r. o świadczeniu usług drogą elektroniczną (Dz.U. 2017, poz. 1219).

LIST OF RESEARCH

Osteoarthritis of the knee
Study description:
Phase III study to evaluate the effectiveness of the study drug in alleviating knee pain.
The main criteria that the patient must meet:
- • documented diagnosis of osteoarthritis,
- • age: ≥18 years,
- • effectiveness or intolerance of previous treatment,
- • advanced degree of degenerative changes,
As part of the study, patients are under the constant care of the attending physician, receive free treatment and have free full diagnostics, such as MRI/X-ray/Blood tests/EGK. The patient is reimbursed for travel expenses for each visit.

SUBMIT FOR THE TEST
Psoriatic Arthritis – conventional treatment
Study description:
Phase 3 study evaluating the efficacy and safety of deucravacitinib in patients with active psoriatic arthritis not treated with disease-modifying biologics.
The main criteria that the patient must meet:
- • age: at least 18 years old,
- • diagnosis of PSA for at least 3 months,
- • no response to conventional treatment.
As part of the study, patients are under the constant care of the attending physician, receive free treatment and have free full diagnostics. The patient is reimbursed for travel expenses for each visit.

SUBMIT FOR THE TEST
Lower lumbar back pain
Study description:
Phase III study to prove the additional benefit of full-spectrum hemp extract VER-01 over opioids in the treatment of patients with chronic non-specific low back pain.
Main criteria::
- • age: at least 18 years old,
- • chronic (at least 3 months) non-specific pain in the lower back,,
- • ineffectiveness or intolerance of previous conventional treatment – non-opioid analgesics (including combinations).
As part of the examination, the patient undergoes full diagnostics at each visit. The patient is also reimbursed for travel expenses for each visit.

SUBMIT FOR THE TEST
COPD
Study description:
Phase III study for patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis.
Main criteria:
- • age: at least 4o years old,
- • diagnosis of COPD for at least 12 months with chronic bronchitis.
As part of the study, patients have full diagnostics and spirometric tests.

SUBMIT FOR THE TEST
Psoriatic Arthritis – biological treatment
Study description:
Phase III study for patients with Psoriatic Arthritis.
Main criteria:
- • age: at least 18 years old,
- • diagnosis of Psoriatic Arthritis for at least 6 months.
- • ineffectiveness of biological treatment.
As part of the study, patient remains under the full supervision of doctor and will have all the necessary diagnostic tests and monitoring performed.

SUBMIT FOR THE TEST
Systemic scleroderma
Study description:
Phase III study evaluating the efficacy, safety and tolerability of the study drug in the form of tablets for patients with generalized systemic sclerosis.
Main criteria:
- • aged between 18 and 75,
- • documented diagnosis of systemic sclerosis,
- • diagnosis of the disease no longer than 3 years from the onset of the first symptom,
- • mRSS ≥15.
As part of the study, patients are under the constant care of the attending physician, receive free treatment and have free full diagnostics (Spirometry, HRCT, echocardiography and DLCO test). The patient is reimbursed for travel expenses for each visit.

SUBMIT FOR THE TEST
Bronchial asthma
Study description:
Phase IV study for patients with bronchial asthma
Main criteria:
- • Men and women aged ≥ 18 and ≤ 75 years,
- • Diagnosis of chronic bronchial asthma for at least one year,
- • A stable treatment regimen with moderate doses of inhaled corticosteroids.
As part of the examination, patients are under the constant care of the attending physician, free full diagnostics and free spirometric tests are performed. The patient is reimbursed for travel expenses for each visit.

SUBMIT FOR THE TEST

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