Sign up now to receive more information and participate in our clinical trials. You can make a difference and help in the development of new, safer and more effective medicines as well as be reimbursed for your time. Step 1 of 3 33% Name* First Last Mobile Phone*Email* Are you able to stay for at least two consecutive days & nights at our centre in Brisbane?*YesNo What is your biological sex?*MaleFemaleDo you currently use any nicotine-containing products (i.e. cigarettes, cigars, tobacco, vaping)?*YesNoHow many cigarettes or equivalent nicotine containing products do you smoke?*Less than 5 per weekLess than 5 per dayBetween 5 and 10 per dayMore than 10 per dayDo you regularly use any recreational drugs? (e.g. marijuana, cocaine, ecstasy)*YesNoWhat is your date of birth?*Day12345678910111213141516171819202122232425262728293031Month123456789101112Year20202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920How tall are you? (In centimeters - e.g. 170)*How much do you weigh? (in kilograms - e.g. 90)*BMI Are you sexually active with a partner/partners of the opposite sex?*YesNoWe have strict contraception requirements for our studies because we need to ensure that your partner does not become pregnant during your study participation. During the study, are you willing to adhere to one of the contraception options below?*YesNo Using a condom + your female partner(s) using birth control You or your partner(s) had a vasectomy/hysterectomy Your partner(s) are post-menopausal Abstinence We have strict contraception requirements for our studies because we need to ensure that you do not become pregnant while the study medication is in your system. During the study, are you willing to adhere to one of the contraception options below?*YesNo You using birth control + your male partner(s) using a condom You or your partner(s) had a hysterectomy/vasectomy You are post-menopausal Abstinence Do you have any severe allergies? (e.g. anaphylaxis)*YesNoDo you have a history of depression or anxiety?*YesNoWhen did you last have treatment for depression or anxiety?*More than 6 months ago or neverLess than 6 months ago or currentlyAre you currently taking medication for your depression or anxiety?*YesNoDo you have a history of asthma?*YesNoWhat is your asthma status?*Childhood asthmaAsthma more than 5 years agoAsthma within last 5 yearsSeasonal asthmaCurrent asthma or within the last 6 monthsDo you have a history of any other medical or mental health conditions? (e.g. Cancer, Hepatitis, eating disorders, high blood pressure)*YesNoWhich of the following conditions have you had? Cancer Coeliac disease Diabetes - Type 1 Diabetes - Type 2 Epilepsy Gastrointestinal problems Hepatitis HIV Liver problems Psoriasis Rheumatoid Arthritis Eating disorder Mental health condition Parkinson's Disease High blood pressure High cholesterol Other If Other, please specify:Apart from hormonal contraception, are you currently taking any prescription medications?*YesNoThe pill, birth control patch, IUD etc. are not prescription medication.Which prescription medication are you taking?Are you willing and able to refrain from alcohol, smoking, medication and recreational drugs during the study?*YesNoThis depends on the study duration, e.g. you might not be allowed to drink alcohol or smoke for two weeksHow did you hear about us?*Friends or familyFacebook or InstagramGoogleAnother websiteEmailA Previous studyRadioTVNewspaper or magazinePlease enter the name of the person who referred you so they are eligible for a $200 referral bonus.I consent to Q-Pharm Pty Limited collecting and using my information in accordance with their Privacy Policy.* Yes You can read our privacy policy here. Participant Registration 1800 934 320