Phone Number

Prefer a callback? Enter your phone number and we'll be happy to get in touch.

(###)

###

####

What is your age range?

<18

18-65

65>

How many years ago were you first diagnosed with schizophrenia?

< 15 years

> 15 years

Which language(s) do you speak?

English

German

None of both

Are taking one of following medications?

Amisulpride, aripiprazole, olanzapine, paliperidone, quetiapine or risperidone

Yes

No

What is your BMI (Body Mass Index)?

<18

Between 18 and 40

>40

Are you pregnant or are you breastfeeding?

Yes

No

Did you participate in a clinical trial during the last three months?

Yes

No

We process your personal data to assess whether you are eligible for participation in our clinical study. This includes information about your health status, which we may only process with your consent. The health data will not be disclosed to third parties. Participation in our questionnaire and the required consent are voluntary and can be revoked at any time without any disadvantages for you. *

I hereby consent to the processing of my health data to determine if I meet the requirements for participation in the study.

In the event that you do not qualify for this study but may be eligible for a future study, we would like to store your data (including health data) and contact you again at a later time. This consent is voluntary. If you do not provide it, we will delete your data and will not contact you again.

I consent to the storage of my data (including health data) for participation in future studies and agree to be contacted for this purpose.

Information on the legal basis for data processing and on the right of those affected can be found in the privacy policy. *

I have taken note of the privacy policy.