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I understand my information is kept confidential in the NWCT patient database and will not be shared with any third parties. If you do not wish for your information to be kept, please ask the recruiter to remove you from our patient database. By entering your personal information on this form, you agree that you are at least 18 years of age and consent to receiving communications (e.g., call, SMS, text, and/or email) from Northwest Clinical Trials. Message and data rates may apply.

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