I want to add my name to the CIU Volunteer Database

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By filling out this form, you agree to the following:

You agree to provide the above information (“your Information”) to the Clinical Investigation Unit (CIU) at the Ottawa Hospital Research Institute (“OHRI”) to add you to a list of people who are interested in participating in research. This list is called the CIU Volunteer Database (the “Database”)1. You are not signing up for any particular research project at this time. The OHRI will store your Information in a secure Database, managed by the CIU. Your Information will be treated as confidential. It will be held and processed under secure conditions following federal and provincial protection laws.

If the OHRI determines that you might be eligible for a particular research study (because of your age or sex), they will contact you to see if you want to participate. You agree that OHRI may contact you by phone or email if they think you are eligible for research. Participation in any study is entirely voluntary. You may choose to participate in one study, but not in another.

OHRI will keep your Information on our Database indefinitely unless you contact us and ask us to remove your Information. You may request your Information be removed from the Database at any time by contacting us using the details provided below. Please note that if you participate or have participated in clinical research, the data collected about you during the study will continue to be stored even if you withdraw from the Database in the future. If you have any queries or wish to update your details, please contact us at CIU@toh.ca or 613-737-8899, Extension 78811.

Declaration (required) By providing my Information, I consent to the above and confirm that the Information I have provided is accurate to the best of my knowledge. *

1 The CIU Volunteer Database is a database used by the Clinical Investigation Unit (CIU) at the Ottawa Research Institute (OHRI) to recruit volunteers for research studies. The OHRI’s CIU uses this database to call potential healthy participants to see if they can help with a research study. This could include volunteering or participating in a clinical trial or donating a specimen, such as a blood test, for laboratory research.