Patients
How you can help…
Patients are the key to quality research. Finding volunteers that meet....
Doctors
Reliable Research
DMI Research can provide you with the support that you need to conduct quality research in your office

Sign-up (to register to win a DMI Research T-shirt, be sure to put "t-shirt" in the comments below)

Name:
Phone:
Address:
Best Time to Call:
Date of Birth:
Sex:
E-mail:
I am interested in information about studies for the following conditions:
Acne
Alzheimer’s Disease
Asthma
Anxiety
BPH
Crohn’s Disease
Constipation (pain medication)
dermatitis
Depression
Diabetes
Dyspepsia
Fibromyalgia
High Blood Pressure
GERD - Heartburn
Gout
Healthy Volunteer
High Cholesterol
Osteoarthritis
Osteoporosis
Pain From Shingles
Peripheral Arterial Disease
Psoriasis
Rheumatoid Arthritis
Restless Legs
Rosacea
Smoking Cessation
Ulcerative Colitis
Weight Loss
Hot Flashes
Incontinence
Irritable Bowl Syndrome
Migraines
Comments:

I understand that the information on this form is personal health information covered under the Privacy Rules.  I agree to allow DMI Research to contact me with study opportunities unless notified otherwise.  This has no expiration.  No personal information will  be shared with any outside parties without prior written consent. 

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