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Recruitment Request
Auxergo Recruitment Request Form
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* Indicates required question
Email
*
Your email
Title
*
Your answer
First Name
*
Your answer
Last Name
*
Your answer
Phone Number
*
Your answer
Company
*
Your answer
Job Title
*
Your answer
What device(s) or product(s) do you want us to study?
*
Your answer
What type of participants do you want us to recruit?
*
Patients
Healthcare Professionals
Nurses includeing training nurses and specialist nurses
Carers
Hospital Managers
Other:
Required
What are your requirements for the participants?
*
Your answer
How many participants do you need?
*
Your answer
Where do you expect the participants to be based?
*
Your answer
When would you like to start the recruitment?
*
Your answer
What is your deadline for recruitment?
*
Your answer
How did you hear about us?
*
Your answer
Auxergo complies with the EU General Data Protection Regulation 2018 (GDPR) and the UK Data Protection Act 2018 (DPA2018) in ensuring the confidentiality of data and ensures that all personal data about participants will be stored securely.
*
Yes
No
Consent
Consent to retain the details for future studies
The information is correct to the best of my knowledge
Yes
No
Consent
Consent to retain the details for future studies
The information is correct to the best of my knowledge
Submit
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