Participant Information Updates

Help us keep our records current by telling us about any updates to your name, contact or medical history information. This will help ensure that you receive any relevant communications from Nutrasource regarding clinical research study opportunities and other news. 

 

This website is a secure website and complies with health information privacy laws.  All information collected will be kept confidential and we do not share your contact information with third parties. 

This form may be used by anyone who currently subscribes to our clinical newsletters.

 

When completing the questionnaire, please do not click your browsers back button.

 

This questionnaire is optional.  If you wish to update your information over the phone, please call our clinic at 519-341-3366 or email us at participate@nutrasource.ca.  

 

Questions marked with an asterisk (*) are required.  All other information is optional. 

 

If you wish to proceed, click the button below to begin.