BAUS North West Urology Research Collaborative Interest Form
Register your interest in joining the regional research collaborative and submitting data on urological conditions.
Full Name
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First Name
Last Name
Email Address
*
example@example.com
Current Trust or Hospital
*
Professional Role/Title
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Are you interested in participating in the North West Urology Research Collaborative?
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Yes
No
Which of the following urological conditions do you currently manage or have clinical involvement with? (Select all that apply)
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Prostate cancer
Bladder cancer
Kidney cancer
Testicular cancer
Urinary tract infections
Benign prostatic hyperplasia (BPH)
Urinary incontinence
Urolithiasis (kidney stones)
Paediatric urology
Andrology
Functional urology
Other
Please provide any additional comments, interests, or relevant experience (optional)
Would you be interested in joining the BAUS North West Urology Research Collaborative committee?
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Yes
No
Submit
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