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Thank you for your interest in participating in one of LEO Pharma clinical trials. Please fill in the form below and click “Submit”. All fields marked with * must be filled in.
If you are a Health Care Professional wishing to refer a potential patient for one of our clinical trials, please fill in your (own) contact information. Be careful not to provide any patient’s personal data.
You will receive a copy of the form by e-mail once you have pressed "Submit".
Disclaimer *
May LEO Pharma share your personal data and contact information with a hospital or clinic conducting a LEO Pharma clinical trial, in order for them to contact you directly? *
Data protection *