Hi. To get started, are you between 18 and 80 years of age? *

Yes

If you are answering this on behalf of someone else.

Please respond to the answers with their details rather than yours. Parents or legal guardians may complete the questionnaire on behalf of someone under the age of 20.

Have you been diagnosed with Crohn's disease by a doctor? *

Yes

How will you know this?

Crohn's disease is usually diagnosed by a gastroenterologist following investigative tests such as a colonoscopy (where a thin, flexible tube with a camera at the end is inserted into your bottom to inspect the bowel), a biopsy (where tiny pieces of bowel are removed during a colonoscopy and then tested), an MRI or CT scan.

Have you had your diagnosis for at least 3 months? *

Yes

Why are we asking?

This clinical trial requires you to have a diagnosis of Crohn's disease for at least 3 months before joining.

Are you currently taking, or have taken, medication for your Crohn's disease? *

Yes

Why is this important?

Our clinical trial requires you to have previously taken medication for your Crohn's disease.

Are you currently, or have you previously, taken a treatment for your Crohn's disease that did not improve your symptoms? *

Yes

Please be aware.

You should not assume that your experience with previous medication will be the same with the investigational medication being tested in our clinical trial.

Have you ever had to stop taking a treatment for your Crohn's disease due to side effects? *

Yes

Please be aware.

You should not assume that your experience with previous medication will be the same with the investigational medication being tested in our clinical trial.

Are you currently experiencing the symptoms of a flare-up (also known as a relapse)? *

Yes

What is a flare-up?

The main symptoms of a flare-up are diarrhea (which may come on suddenly), stomach aches or cramps and blood in your stool. You may also feel extremely tired and experience weight loss.

Have you undergone surgery for either an ileostomy or a colostomy? *

Yes

Why are we asking this?

Previous surgery may affect whether or not you can take part in our clinical trial.

Find your closest study site

The next step is to select a study location that is convenient for you, and then to speak with the study doctor or a member of the study staff so that you may learn more about the study. You may then decide whether you would like to make an appointment to see if you are fully eligible to participate.

Select your nearest study site *

Select a study site that is closest to you.

Nearly there...

Fill out the form below and we will be in touch.

Havas Faze or contacting you about Crohn's disease and similar inflammatory bowel disease (IBD) trials run by and that we are recruiting for, by email, telephone, MMS or SMS or other messaging channels.

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Your details

First Name *

Last Name *

Date Of Birth *

Sex *

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Let us get in touch

Email address *

Phone *

Mobile number

If you have provide your number, we will send you a further SMS shortly to obtain your opt-in consent

What is your preferred method of contact? *

SMS

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Health Data Processing Consent

In order to evaluate your eligibility for the clinical trial you have expressed an interest in as well as other Crohn's and similar IBD trials run by (that Havas Faze is recruiting for), we need to collect and process the health information you provided through the questionnaire.

Consent to evaulate eligibility *

By checking this box, you consent to Havas Faze collecting your health information for the above purposes.

If you do not consent, we will not be able to evaluate your eligibility for the (current and future) clinical trials offered, to proceed with your application and to invite you to participate in the trial(s).

Contact Consent

In order to invite you to participate in these trials, and discuss your eligibility, we also need to contact you.

Contacting you *

By checking this box, you consent to Havas Faze and/or a clinical study site contacting you (by email, telephone, SMS or any other messaging channels (such as WhatsApp) to discuss your eligibility.