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Join Cure Pursuit

Thank you for your interest in Cure Pursuit!

Cure Pursuit provides a way for you to influence the direction of medical research and the development of medical products to treat your own illness. You will be compensated for your completed survey responses.

In order for CurePursuit to provide our panelists with access to appropriate surveys, we ask our panelists to register by responding to the brief set of questions found below. The privacy and safekeeping of any personal information provided by our panelists is our top priority. We do not share any information that personally identifies our panelists to any third party including the biotech, pharmaceutical and medical device companies who receive the completed surveys.

All fields are required.

1. Contact/Login Information
E-mail Address*
Password *  
Password repeat*  
First name*
Last name*  
Country*
Street 1*
Street 2
City*
Province/State*
Postal Code*
Gender*   Male   Female
Date of birth *      Day     Year  
Language *  
2. Incentives
  Vivisimo Biomedical Tool Subscription  
Cash Honorarium  
3. Health Problems
Please check medical conditions found in your household. Check all that apply:
   Acid Reflux
   Allergies
   Alzheimer's
   Anemia
   Anxiety
   Rheumatoid Arthritis
   Asthma
   Attention Deficit / Hyperactivity Disorder
   Autism
   Back Problems
   Bipolar Disorder
   Birth Defect
   Brain Tumor
   Breast cancer
   Brain cancer
   Colon cancer
   Liver cancer
   Lung cancer
   Oral cancer
   Ovarian cancer
   Pancreas cancer
   Prostate cancer
   Skin cancer
   Stomach cancer
   Testicular cancer
   Other kind of cancer
   Celiac Disease
   Crohnes Disease
   Chronic Fatigue Syndrome
   COPD (chronic obstructive pulmonary disease)
   Chronic Pain
   Cystic Fibrosis
   Depression
   Diabetes- Type 1
   Diabetes- Type 2
   Dyslexia
   Eating Disorders
   Eczema
   Emphysema
   Endometriosis
   Epilepsy
   Erectile Dysfunction / Impotence
   Fibromyalgia
    Fibromyalgia
   Headaches
   Heart Conditions
   Hearing Problems (deafness, ringing in ears etc.)
   Hepatitis
   Herpes
   High Blood Pressure
   High Cholesterol
   HIV/AIDS
   Hypoglycemia
   IBS (irritable bowel syndrome)
   Kidney Condition
   Leukemia / Bone Marrow Conditions
   Lupus
   Lyme Disease
   Lymphoma
   Mental Retardation
   Migraine Headaches
   Multiple Sclerosis
   Obesity
   Obsessive Compulsive Disorder
   Onychomycosis (nail fungus)
   Osteoarthritis
   Osteoporosis and Bone Diseases
   Parkinson Disease
   Physically Disabled
   Prostate Condition
   Psoriasis
   Restless Leg Syndrome
   Scoliosis
   Seizures
   Sight and Hearing Disability
   Sinus Problems
   Sleeping Disorder
   Spondylitis
   Thyroid Disease
   Tourette's Syndrome
   Vision Problems (blindness, glaucoma etc.)
   None
   Other (please specify):
   Dementia
   Schizophrenia
   Substance Abuse
If Other, please specify:
4. Health Problems
How long medical condition has been observed?*
Are you receiving treatments for your condition at this time?* Yes   No
Have you participated in clinical trials?* Yes   No
Would you be interested in participating in a compensatory clinical trial applicable to you?* Yes   No


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