Vaccine trials will need to enroll many people in a short period of time. To help with recruitment for these trials, we are keeping a registry of people who are interested in participating. Then we will use this pool of people to contact them in the future if they are eligible for the different trials.
Can I be in the registry?
You can be in the registry if you are a) 18 years of age and older and b) in general good health (or with stable medical conditions).
What happens if I complete this form?
If you complete this form, you will be asked to answer questions about your general health and some questions that will help us determine if you are eligible. We will also ask you to provide us with some basic demographic information such as gender, age, date of birth and race and finally we will ask for your contact information (name, phone number and email). We will use your contact information to call you if you are eligible to participate in one of our vaccine trials. At that time, we will explain all the details of the specific trial and ask you if you want to participate. By completing this form, you are only providing us your permission to contact you.
If you start completing the form and you change your mind, please just close the window and do not submit this form. If you complete (and submit) the form and then you change your mind, please let us know and we will delete your responses.
We will keep your survey responses for at least 6 years. After that time, your responses will be deleted. We can also delete your responses anytime at your request.
Records of your participation in the registry will be held confidential except as required by law. The investigator, and under certain circumstances other bodies such as the Institutional Review Board (IRB), will be able to inspect and copy confidential registry-related records which identify you by name. This means that absolute confidentiality cannot be guaranteed. Your health information is protected by a federal privacy law, called HIPAA. Data collected for this registry is part of that protected health information. By joining the registry, you are giving us permission to collect and review your health information as described above.
Your participation in the registry is completely voluntary. Choosing not to participate will not affect your relationship with Hackensack Meridian Health including your employment relationship. Participating will not benefit you in any way. Also, there will be no costs or compensation if you choose to take part.
What if I have questions?
If you have questions or concerns about the registry or if you change your mind and would like to be removed from the registry, please call us at 551-996-5977.
If you have questions about your rights as a research participant please contact the Research Integrity Office at 201-880-3669.
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