Register your interest

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If you have had COVID-19 and would like to register your interest in taking part in the GenOMICC COVID-19 study, please complete the form below - please only register your interest if you are 16 years old or above and resident in the UK.

If you would like to read more about the study, click here to return to our main COVID-19 page.

Your personal data will not be used for purposes other than to contact you regarding our COVID-19 research study – read our privacy notice.
 

1. First name *

 

2. Last name *

 

3. Date of birth *

   DD/MM/YYYY 
 
 

4. Gender *

 

5. Ethnicity *

 

6. Postcode (first half only, e.g. W1A or BR12) *

 

7. Email address *

 

8. Phone number

 

9. Have you been tested for COVID-19? *