STEP ONE

Answer a short survey

STEP TWO

Let us know how to contact you

STEP THREE

Get a call to schedule your visit

To put you in touch with the study center you’ve selected, we need to know a little bit more about you.

Your contact details will be provided to the study team so that they can contact you to further determine if you qualify for this study. We will also provide you with a confirmation email with the contact details of the study center you’ve selected so that you may reach out to VRC on your own.

Please provide your contact information in the form below. All fields marked with an (*) are required.

* First Name:

* Last Name:

* Gender:

* Email Address:

* Phone Number:

* Is this a mobile device?:

* May a study team member contact you via SMS text message? (Message and data rates may apply.):

* Can the study team leave you a voicemail?: Yes No

* What is the best time of day to contact you?:

* How did you hear about the study?:

Do you agree to have a member of the study team contact you to discuss the study in more detail?

* I agree to have the study team contact me.

We are committed to keeping your personal information safe and secure. Please see our Privacy Notice.

It’s a great feeling knowing you potentially helped find a solution to a problem that many others face with their vision.

STEP ONE

STEP TWO

STEP THREE

It’s a great feeling knowing you potentially helped find a solution to a problem that many others face with their vision.

- Gabrielle, actual study participant

More questions? Get answers.

STEP ONE

STEP TWO

STEP THREE

It’s a great feeling knowing you potentially helped find a solution to a problem that many others face with their vision.

- Gabrielle, actual study participant

More questions? Get answers.

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