Apply Online | The Rowett Institute | The University of Aberdeen

HISU Volunteers Form

Personal Details

Name *

Address *

Contact Number *

Date of Birth *

Gender *

Health

Height (cm) *

Weight (kg) *

Do you smoke? *

Yes

If so, how many a day

If stopped, when did you stop (year)

What is your alcohol consumption? (number of drinks per week)

Are there any foods you will not eat or do you eat any particular diet? (eg vegetarian, gluten free weight loss, include any allergies) *

Do you take any supplements? (eg vitamin tablets, fish oils). *

Have you been diagnosed with any chronic illness? (eg diabetes, heart disease, thyroid disorder) *

Detail any serious illness or operations *

Detail any prescribed or regular medication you take (eg painkillers, oral contraceptives) *

Join our Studies

Are there any studies that you'd like to take part in? (List of Current studies)

Would you like your name added to our volunteer database to receive information of other studies that you may be eligible for? *

Yes

How did you hear about us or the study of interest? *

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