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EXAMPLE1 Contact

Self-Screening – Contact Us

This page is displayed when the questionnaire results indicate that the participant
would be eligble to apply for the trial. The questions below can be customised to the needs of the trial.

When the submit button is pressed, an email containing all the responses from this form will be sent to the trial inbox (or any nominated email address). For this example, the email will be sent to the address you provide so you can see how the information is presented in the trial inbox email.

This page will need a brief privacy statement to cover it for GDPR.

Please provide your full address, including your postcode