Application to Join the Independent Worldwide Endobarrier Registry and
Gain Access to the On-line Registry Tool

To join the registry  and have access to the secure on-line registry tool which will allow local analysis and storage of your own data, national analysis of all the data in your country, as well as automatically providing the data in anonymised form to the worldwide analysis, simply complete and submit the form below.

Every Centre should designate a lead clinician whose details should be supplied with the application.
Please provide the following information:

Title
 
Name
 
Designation (Professor, Doctor, Nurse, Trainee etc)
Hospital, Surgery, Town(*required)
 
Postcode / ZipCode
 (*required)
Country(*required)
Your telephone number
 
Your email(*required)
 
Lead clinician name and title (*required)
Lead clinician telephone number
Lead clinician email(*required)
 
   
Further information (including your Centres experience with Endobarrier, approximate number of patients etc)

 

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Revised: 10/04/21.