211216 Screening About you Page1 / 1 Question Title * 1. What is your First Name Question Title * 2. What is your Surname Question Title * 3. Please enter your Date Of Birth Date of Birth Date Question Title * 4. Are you Male Female Question Title * 5. Please enter a contact telephone number Question Title * 6. Please enter your email address (Please ensure that this is correct or we cannot accept you onto the study) Question Title * 7. Do you smoke 5 or less cigarettes per week? Yes more than 5 per day Yes less than 5 per day No Question Title * 8. Are you aged 28 - 37? Yes No Question Title * 9. Are you currently using a hormonal contraception? Yes No Question Title * 10. Would you rather attend our Paisley or Edinburgh office? Paisley Edinburgh Done
