Participating in Research Studies

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To receive information about available research studies, please provide the following information:

Last Name:
First Name:
Date of Birth: (Month/Day/Year)
Sex	Male Female
Mailing Address:
Telephone Number:
E-mail Address:

Are you a Healthy, non-smoking - female, aged 20-47, or - male, aged 20-50?	Yes No
Do you have a Body Mass Index of 22 to less than 28 (Not Sure? Click Here )	Yes No
Are you free from diabetes, cardiovascular disease or any other cronic physical or mental condition?	Yes No
Are you a woman who is not pregnant, breast-feeding or planning to become pregnant during the 2 year study period?	Yes No
Are you planning to remain in the Boston area during the 2 year study period?	Yes No
How did you hear about the HNRCA research studies?	Boston Globe Boston Herald Boston Metro Radio Television Flyer/Poster Mailing Internet Other

Thank you for your interest. We will send you an application form about our studies. For further information, please call the HNRCA Volunteer Services at (800) 738-7555.

Privacy Statement: The privacy of visitors to our web site is important to us. The personal information you provide to the Volunteer Services department will remain strictly confidential and will not be shared with third parties.