Study Registration Form

If you would like information for study participation, please select from the following:

Kendle now offers online registration for studies. If you wish to receive information about a particular study, or if you would like to learn more about Kendle and our studies, please fill out the online registration form. After submitting your information, a Kendle recruiter will call you within 24 hours. The following registration information is used only for scheduling screening appointments at Kendle International Inc. This information is for the private use of Kendle International Inc., and is not disclosed to any other companies.

If you wish to receive information about more than one specific study, please fill out the form separately for each study. If you wish to receive general Kendle information or information about all studies, select the "need more information" option. You can fill out the form as many times as you wish. If new studies are added to the Current Studies page, feel free to fill out a new form to request new information.

First Name	MI	Last Name	Last 4 digits of your Social Security #

Phone Number: Extension:

Alternate Phone Number: Extension:

Email Address:

Sex: Male Female

Height: Feet: Inches:

Weight: Age: Date of Birth (mm/dd/yyyy):

Are you allergic to any medications? If yes, please list:

Availability:

How did you hear about Kendle?

Have you used tobacco products including smoking in the past year? Yes No

Are you currently taking any medications? Yes No

Do you have any illnesses or diseases? If yes, please list:

Can you pass a drug screen? Yes No

Have you donated blood or blood products including plasma within the past 30 days? Yes No

Have you participated in a Clinical Drug Study in the last 30 days? Yes No

Do you have any dietary restrictions? Yes No

What study are you interested in?

Study I-Study Code ES26
Study II- (Code DE7)
Study III- Code FN36
Study IV- Study Code FN35

Need more information